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Pelvic resections.

Andreas F Mavrogenis1, Konstantinos Soultanis, Pavlos Patapis

  • 1First Department of Orthopaedics, ATTIKON University Hospital, Athens University Medical School, Athens, Greece.

Orthopedics
|February 8, 2012
PubMed
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Surgical treatment for pelvic bone sarcomas has evolved from amputation to limb-salvage surgery. Limb salvage is preferred when wide margins can be achieved without compromising survival or function.

Area of Science:

  • Oncology
  • Orthopedic Surgery
  • Skeletal System Neoplasms

Background:

  • Pelvic bone sarcomas present complex treatment challenges due to anatomy and tumor extent.
  • Historically, hindquarter amputation was the primary surgical intervention.
  • Advancements enable limb-salvage surgery as a viable alternative to hemipelvectomy.

Purpose of the Study:

  • To review the evolution of surgical treatments for primary pelvic bone sarcomas.
  • To compare amputation versus limb-salvage surgery outcomes.
  • To discuss indications and challenges in pelvic sarcoma resection and reconstruction.

Main Methods:

  • Review of historical and current surgical techniques for pelvic bone sarcomas.
  • Comparison of outcomes between amputation and limb-salvage procedures.

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  • Analysis of factors influencing surgical decision-making, including nerve involvement and reconstruction.

    • Main Results:

    • Limb-salvage surgery and reconstruction are now feasible alternatives to amputation.
    • Amputation offers lower complication rates and faster recovery but results in functional deficits.
    • Periacetabular resections can lead to leg-length discrepancy and impaired gait.
    • Sciatic nerve resection significantly impacts limb salvage viability; femoral nerve resection has less gait impact.

    Conclusions:

    • Limb salvage is indicated when wide surgical margins are achievable without compromising oncologic outcomes or function.
    • Reconstruction after major pelvic resections, especially acetabular involvement, remains challenging.
    • Surgical decision-making must balance oncologic control, functional preservation, and patient survival.