Segmental amputation with re-implantation in the treatment of malignant bone tumours of the limbs.
Stage 2 B malignant skeletal tumours are currently treated by amputation or disarticulation of the limb. The present paper describes a surgical technique for complete removal of the neoplasm and surrounding soft tissues by resection of a cylinder of the limb complete with skin. The resection of bone and adjacent soft tissues is extended sufficiently proximal and distal to the neoplasm to ensure complete removal of neoplastic tissue. The authors describe two cases; an osteosarcoma of the distal third of the femur and a malignant fibrous histiocytoma of the lower radius. After removing the affected cylinder of the limb, osteosynthesis is performed by one of a variety of methods. The main vessels and nerves are dealt with according to the findings revealed by pre-operative investigations or per-operative findings. If they have to be sacrificed, end to end suture is performed, but if main nerves can safely be spared (as in Case 1) it greatly enhances the functional prognosis. The value of this operation is that it is as radical as amputation while the aesthetic and functional results are equivalent to those of a resection-arthrodesis. The operation has therefore been designated segmental amputation.
D000328:Adult; D000671:Amputation, Surgical / Q000379:methods*; D001843:Bone Cements; D001852:Bone Lengthening / Q000379:methods; D001858:Bone Nails; D001859:Bone Neoplasms / Q000601:surgery*; D002370:Casts, Surgical; D005266:Femoral Neoplasms / Q000601:surgery*; D018219:Histiocytoma, Benign Fibrous / Q000601:surgery*; D006801:Humans; D008297:Male; D012516:Osteosarcoma / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery; D011884:Radius / Q000601:surgery*; D012092:Replantation; D013536:Suture Techniques
D001843:Bone Cements