title: Reconstruction of the pelvis and lumbar-pelvic junction using 2 vascularized autologous bone grafts after en bloc resection for an iliosacral chondrosarcoma.
abstract: Primary pelvic sarcomas remain challenging and complex surgical problems with significant potential for postoperative impairment of ambulation, as well as bowel, bladder, and sexual function. En bloc resection with negative tumor margins represents the best chance of control or cure as current adjuvant therapies remain ineffective. Tumor involvement of the sacrum with extension to the greater sciatic notch and ipsilateral ilium requires an external hemipelvectomy and sagittal sacrectomy with sacrifice of the lower extremity to achieve en bloc resection, followed by lumbar-pelvic reconstruction. A patient with an iliosacral chondrosarcoma is presented to illustrate a novel lumbar-pelvic reconstruction technique, in which vascularized soft tissue and 2 vascularized bone grafts were harvested from the amputated lower extremity and transferred to the pelvis as composite flaps to restore pelvic ring integrity, augment lumbar-pelvic fusion, and close the soft-tissue defect. The biomechanical dynamics of this unique construct are discussed.
authors.affiliation: Department of Neurologic Surgery, The Ohio State University Medical Center, Columbus, Ohio 43210, USA. ehud.mendel@osumc.edu
authors.forename: Ehud
authors.initials: E
authors.lastname: Mendel
authors.forename: Joel L
authors.initials: JL
authors.lastname: Mayerson
authors.forename: Narendra
authors.initials: N
authors.lastname: Nathoo
authors.forename: Rick L
authors.initials: RL
authors.lastname: Edgar
authors.forename: Carl
authors.initials: C
authors.lastname: Schmidt
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Miller
mesh_terms: D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery; D016025:Bone Transplantation; D002813:Chondrosarcoma / Q000473:pathology / Q000601:surgery; D006801:Humans; D007085:Ilium / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012447:Sacrum / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome