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The swing procedure for pelvic ring reconstruction following tumour excision
R C Pollock1, J A Skinner, G W R Blunn
1The London Bone and Soft Tissue Tumour Service, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA74LP, UK. rob@pollock39.freeserve.co.uk
Aim:
High grade periacetabular osteosarcomas extending to the sacro-iliac region present a difficult management problem. We describe our experience of the swing procedure as a method of limb salvage.
Method:
The procedure was performed on three patients with stage II B osteosarcoma.
Results:
Functional outcome was poor in all three with a mean Musculoskeletal Tumor Society score of 29% (27-30) at last review. All three developed local recurrence and one developed pulmonary metastases. The mean disease free interval post-operatively was 4.7 months (4-6) and they died of their disease at a mean of 10 months (5-16).
Conclusions:
This form of limb salvage is technically demanding and carries a high morbidity. Functional outcome is poor and the prognosis for this group of patients is not improved by surgery. Alternative treatment options are discussed.