Since the early 1970s, substantial progress in dealing with musculoskeletal tumours has been made, with improvements in surgical skills, radiology, chemotherapy, pathology, and radiotherapy. Nowadays, 70-85% of all malignant tumours are treated by limb salvage, without compromising the oncological result. After many years, the functional result that may be achieved with a limb-saving procedure is becoming clear. Limb salvage has cosmetic advantages, but whether the quality of life of these patients is superior to that of those who undergo amputation is unclear. The non-oncological complication rate is much higher after limb salvage than after amputation, and consequently additional surgery is necessary. In the future, the co-operating disciplines should strive for better survival of these patients, for which the development of new chemotherapeutic drugs is especially needed.
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http://dx.doi.org/10.1016/s1470-2045(03)01114-8 | DOI Listing |
J Clin Orthop Trauma
February 2025
Instituto de Ortopedia y Trauma Dr. Jaime Slullitel, San LUIS 2534 2000, Rosario, Santa Fe, Argentina.
Introduction: In the scenario of chronic osteomyelitis following an ankle fracture, limb salvage and ideally infection eradication, can be an alternative to amputation.Tibiotalocalcaneal arthrodesis is perhaps the most popular procedure. When performing fusion in osteomyelitis patients, external fixation is more commonly used, although there is some experience with internal fixation.
View Article and Find Full Text PDFJ Pak Med Assoc
January 2025
Department of Plastic Surgery, Shifa International Hospital, Islamabad, Pakistan.
Objective: To assess the functional outcomes of patients undergoing lower limb reconstruction with vascularised fibula following tumour resection in a tertiary care setting.
Methods: The single-centre, retrospective, observational study was conducted at the Shifa International Hospital, Islamabad, Pakistan, and comprised data from January 1, 2017, to December 31, 2022, of patients who underwent lower limb reconstruction with vascularised fibula following oncological resection. Functional outcome was assessed using Musculoskeletal Tumour Society score.
BMJ Open Diabetes Res Care
January 2025
Department of Surgery, Woodlands Health, Singapore
Introduction: To compare the clinical outcomes and healthcare utilization of patients enrolled in the multidisciplinary Diabetic Foot in Primary and Tertiary (DEFINITE) Care program with a matched historical cohort and estimate the program's long-term cost-effectiveness using simulation.
Research Design And Methods: This study consisted of two components: a 1-year observational outcome evaluation and a long-term simulation-based cost-effectiveness analysis (CEA). We conducted an observational study to analyze 2798 patients with diabetic foot ulcers (DFUs) enrolled in the program between June 2020 and June 2021 (DEFINITE Care group) and 5462 patients with DFUs from June 2016 to December 2017 as historical controls.
BMJ Case Rep
January 2025
Department of Orthopaedic Surgery, Pontificia Universidad Catolica de Chile, Santiago, RM, Chile
The hindfoot is an uncommon site for malignant tumours. While limb salvage procedures are now more common for treating bone sarcoma, there is limited information available on hindfoot reconstruction alternatives because of its low incidence and its challenging outcomes. We present a case report of a man in his late 60s with synovial sarcoma affecting the right heel (calcaneus and soft tissue).
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Department of Plastic Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Introduction: Soft tissue defect in the lower limb presents as a difficult reconstructive challenge. Cross-leg flap was routinely used in the past for the salvage of the lower limb but is seldom used nowadays due to advances in microsurgical procedures.
Case Presentation: We present a case of an 18-year-old male who presented with a complex soft tissue defect of 25 × 10 cm on the anterolateral aspect of the right leg following a motor vehicle accident.
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