Limb salvage surgery: an advance in surgical technique

"Surgery is the primary and oldest treatment for malignant musculoskeletal tumors. Until the 1970's amputation was the accepted surgical procedure for patients with malignant tumors of the extremities. Recent advances in adjuvant treatment modalities such as chemotherapy and radiotherapy, bioengineering designs of internal prosthetic devices, radiographic workups, and bone and tissue transfers provide some individuals with the option of limb-preservation" (Lewis, 1992, p. 477-478). One limb salvaging technique uses a metallic implant to replace resected tumors of the bone. It is this surgical orthopaedic advancement that is currently being used in the resection of primary malignant bone tumors of the lower extremities at Mount Sinai Hospital, Toronto, Ontario. The objectives of this paper are to review the management of musculoskeletal tumors in "skeletally mature patients", and to review a system currently being utilized at Mount Sinai Hospital which provides a surgical option for resection and reconstruction of malignant bone tumors. The role the perioperative nurse plays in providing care to patients having limb salvage surgery will also be described. All three objectives will provide insight into the challenges facing orthopaedic oncology patients who are living with cancer.