Surgical limb-sparing in veterinary medicine: A review of existing techniques in dogs

Surgical limb-sparing in veterinary medicine can be defined as an intervention aimed at preserving limb function when a bone abnormality is present, namely neoplasia or a non-repairable fracture, and the affected segment of that bone needs to be removed and, most often, replaced. In some cases, the affected segment of bone is treated and reimplanted. It is mostly prevalent in the context of local tumor control while preserving limb function in veterinary surgical oncology but has also been employed for comminuted fracture repair. Importantly, this review focuses on neoplasia and non-repairable fractures wherein the bones were normal prior to the pathology and the non-affected segments of bone remain normal in the face of the pathology. Several techniques have been reported and vary based on a number of factors such as anatomic location of the pathology and method of addressing the defect created by removal of the affected bone segment. Limb-sparing techniques have been documented to have comparable survival times to limb amputation but can be fraught with mechanical and biological complications, requiring intensive long-term care and client compliance with treatment regimens. The most common complications are infection, mechanical failure, and local recurrence. Decreasing the risk of complication is the driving force for research in the field of limb sparing in dogs. The aim of this review was to compile the existing literature on surgical limb-sparing in dogs with the intent to guide clinical decision-making and inform further research on limb-sparing.