Internal hemipelvectomy.
Until recently, tumours involving the pelvis were usually treated by hemipelvectomy, otherwise called "hindquarter amputation". A more recent approach of treating these tumours is the 'conservative hemipelvectomy', which consists of removing the tumour and sparing the lower extremity. A patient with Ewing's sarcoma of the pelvis underwent such a procedure. The femoral head was fixed temporarily to the remaining parts of the acetabulum and the iliac wing by a Steinman pin. The Steinman pin was removed 6 weeks after the operation and the patient was then put into traction for another 6 weeks. Weight-bearing was gradually allowed after 3 to 6 months. The patient remodelled a neoacetabulum, which gave sufficient stability to the hip joint. Walking without external help was possible. The patient presented with a 2 cm limb-shortening. No local recurrence was observed during a follow-up of 30 months. This experience with internal hemipelvectomy shows an encouraging result in terms of tumour control and gait function.
Hamdi
M
M
Department of Surgery, Jules Bordet Institute, U.L.B., Brussels, Belgium.
Gebhart
M
M
Recloux
P
P
D000328:Adult; D001858:Bone Nails; D001859:Bone Neoplasms / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D010384:Pelvic Bones / Q000503:physiopathology / Q000601:surgery*; D012512:Sarcoma, Ewing / Q000503:physiopathology / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods; D016138:Walking; D016474:Weight-Bearing