Written informed consent was obtained from the patient for publication of this Case report and any accompanying images. Radiation therapy also has an established role in treatment of soft tissue sarcomas. 2020; 122(8):1693-1710 (ISSN: 1096-9098) Anderson SR; Wimalawansa SM; Roubaud MS; Mericli AF; Horne BR; Valerio IL. https://doi.org/10.1186/1477-7800-5-1, DOI: https://doi.org/10.1186/1477-7800-5-1. Scopus. Am J Surg. Download Full PDF Package. Preoperative radiation’s disadvantages include a higher rate of wound problems and less viable tumors available for pathologic examination. The surgical resection in our Case was much more extensive, with the removal of entire hemi-pelvis and femur. With the patient in the lateral position the incision is made through the anterior abdominal wall, and the iliac vessels are dissected free and divided just distal to the aortic bifurcation. Michael Kralovec. Targeted muscle reinnervation following external hemipelvectomy or hip disarticulation: An anatomic description of technique and clinical case correlates. The fore- and mid-foot are then resected. Level of Evidence: Level IV, therapeutic study. This paper. The rate of local recurrence was reported from 23 to 30 % [14,15,20,21]. If additional procedures on spine, sacrum, or rectum need to be performed, intraoperative repositioning of the patient will be required (, Low sacral resection can also be performed in the “sloppy” lateral decubitus position (, Pelvic reconstruction following external hemipelvectomy is principally accomplished with three pedicled flap designs: posterior, long anterior, and total thigh fillet flaps. Part of Most patients with high grade bone malignancies will undergo some form of neoadjuvant treatment, including chemotherapy and/or radiation therapy prior to tumor resection. 97 Renal Artery Revascularization. He presented for lameness initially, but progressed to severe neurological deficits. COVID-19 Collection. Tumor resection typically results in severe bone loss and reconstruction can be challenging. Hemipelvectomy utilizing an anterior myocutaneous flap: case report and surgical technique description. Osteotomy was created in metaphyseal bone at the distal femur. Postoperative radiation has the advantage of earlier surgery, viable tumors for pathologic study, and fewer wound complications. When a tumor is not able to be resected with the use of a limb-sparing technique or via hip disarticulation, a hemipelvectomy may be required. An external hemipelvectomy … It was initially recommended that gluteal muscles be left with the specimen. Extensive defects of the pelvis and sacrum can result from tumors, ablation, and severe trauma. Coverage for endoprostheses or allografts, Addresses functional deficits (neurotized flaps). CAS She was initial treated 10 years ago with radical radiotherapy, following which she developed local recurrence after 5 years. Springer Nature. Hemipelvectomy reconstruction with a microvascular fillet flap obtained by ex-vivo anatomic exploration of an amputated extremity is an underutilized reconstructive option and should be considered in the cases of paucity or poor quality of local tissues and vascular ligation above the bifurcation of common iliac vessels that is plagued with the high rate of flap necrosis rate. The answers to these questions have to be determined during preoperative evaluation by the surgical oncologist, reconstructive surgeon, and anesthesiologist. We reviewed our experience using the T-incision technique for … "Hemipelvectomy" is a descriptor in the National Library of Medicine's controlled vocabulary thesaurus, MeSH (Medical Subject Headings).Descriptors are arranged in a hierarchical structure, which enables searching at various levels of specificity. Key words: hindquarter amputation: hemipelvectomy Accepted 5.iv.77 Hindquarter amputation is synonymous with hemipelvectomy, disarticulation of tlic innominate bone, interilio-abdominal ;imputation, sacroiliac disarticulation, transiliac amputation, interpclviabdom- jnal amputation and transpelvic amputa- tion. In 1959, Gordon-Taylor reported on his experiences with hindquarter amputations in a series of … Clin Orthop Relat Res. Despite the fact that the majority of patients with pelvic sarcomas can be safely treated with chemotherapy and limb-salvage surgery, [2] in a number of patients external hemipelvectomy is still required to achieve wide margins. Posterior Flap Hemipelvectomy Martin M. Malawer James C. Wittig BACKGROUND Despite increasingly effective chemotherapy and advances in limb-sparing surgery around the pelvis and hip, hindquarter amputation (hemipelvectomy) often remains the optimal surgical treatment for primary tumors of the upper thigh, hip, or pelvis. J Bone Joint Surg Am. Conclusions. Chretien PA, Sugarbaker PH: Surgical technique of hemipelvectomy in the lateral position. Results show that external hemipelvectomy in our patients have a high morbidity and mortality rate. the surgical technique (external hemipelvectomy [amputa-tion] or internal hemipelvectomy [limb sparing surgery]) on anesthesia and perioperative care in Brazil. 1981, 90: 900-909. It consists of resectioning the hemipelvis and the ipsilateral extremity. Introduction Removal of a diseased, injured or no longer functional extremity. After radiographic union, all devices were Privacy By using this website, you agree to our Atlas of Advanced Operative Surgery E-Book : Advance your surgical expertise with Atlas of Advanced Operative Surgery! Because external hemipelvectomy resulted in major functional impairment, limb-sparing procedures removing part or all innominate bone with preservation of the extremity have been advocated. 4. Although data pertaining to the technique are scant, it appears the prognosis for hemipelvectomy … The patient was positioned in a floppy semi-lateral position on the operation table. Technique . Can the residual defect or deformity from the proposed resection be reconstructed in a functionally satisfactorily manner with stable soft tissue coverage? The calf with its vascular supply is rotated by 180 degrees. J Bone Joint Surg Am. Top Contributors - Contents. McDonald DJ, Scott SM, Eckardt JJ: Tibial turn-up for long distal femoral bone loss. Standard MRI of the female pelvis at our institution includes coronal single-shot fast spin-echo (FSE), axial T2-weighted (T2W) FSE, axial in-phase and opposed-phase T1-weighted (T1W) gradient-recalled echo (GRE), and sagittal T2W FSE fat-suppressed sequences utilizing a dedicated pelvic phased-array coil (see Table 3). Musculoskeletal malignancies have a propensity to pulmonary spread. Posterior Flap Hemipelvectomy Martin M. Malawer James C. Wittig BACKGROUND Despite increasingly effective chemotherapy and advances in limb-sparing surgery around the pelvis and hip, hindquarter amputation (hemipelvectomy) often remains the optimal surgical treatment for primary tumors of the upper thigh, hip, or pelvis. Complications of the radiation treatment included radiation colitis which resulted in a partial small bowel resection ten years prior to the One of the major limitations of the posterior flap external hemipelvectomy is its inability to deal with the advanced tumors of the buttock and posterior pelvis in an oncologically sound manner. Methods. (Figure 3) The quadriceps muscle flap was then sutured to the fillet flap on the calf, thereby forming a neo-thigh stump. From January 1985 through December 2005, 160 patients underwent external hemipelvectomy in two integrated tertiary-care hospitals in our institution. A fillet flap of the foot was made based on the dosalis pedis pedicle dorsally and the posterior tibial pedicle medially. Hemipelvectomy, the classic treatment for these lesions, has been associated with dismal functional and psychological outcomes. This position is preferred for internal or external hemipelvectomy because it permits a wide skin preparation and an easy access to the abdomen, buttock, and perineal regions. Complications and outcome of external hemipelvectomy in the management of pelvic tumors. 2 External hemipelvectomy involves amputation of the lower extremity along with the hemipelvis . The author(s) declare that they have no competing interests. Design: Retrospective review of 68 external hemipelvectomies performed at our Institute between 1973 and 1994. Jump to:navigation, search. Standard hemipelvectomy flaps provide adequate soft tissue coverage, and there is no difference in postoperative wound complications related to flap design. J Orthop Surg (Hong Kong). Alternative to hindquarter amputation (external hemipelvectomy) with substantial risk of LR or infection; Indications. An x-ray of a limb sparing hemipelvectomy of a male pelvis taken one month after surgery. There are two types of hemipelvectomy: External - Amputation of the whole leg plus the pelvis on that side. Another name for external hemipelvectomy is hindquarter amputation. Internal - Removal of the pelvis on the one side, but without removal of the leg. Article 68 year-old female presented to our unit with a 10 year history of recurrent malignant fibrohistiocytoma involving left pelvis and femur. Date 2008-01-21. 93 Carotid Endarterectomy/Stent Placement. Michael Kralovec. Ilizarov technique: A bone fixation technique using an external fixator for lengthening limbs, correcting pseudarthrosis and other deformities, and assisting in the healing of otherwise hopeless traumatic or pathological fractures and infections, such as chronic osteomyelitis. Therefore, a chest CT is mandatory to screen for systemic disease. Likewise, extensive buttock defects inflicted by trauma, infection, or end-stage pressure ulcers in paraplegics could not be effectively reconstructed. Proper technical execution of the procedure and the use of well-designed skin and muscle flaps can minimize postoperative wound morbidity. Epub 2019 Jun 13. Prior to performing a hemipelvectomy, surgeons must possess detailed knowledge of the pelvic anatomy and its relation to the pelvic tumor. The incision then curved around the posterior superior iliac spine and ran inferiorly approximately 5 cm lateral to the anus. American Journal of Physical Medicine & Rehabilitation, 2014. Hemipelvectomy is a surgical procedure that involves the removal of the pelvic bone and sometimes the limb. Surgical planning relies on MRI images taken before and after neoadjuvant therapies. 9–11 It is evident that not only surgical technique but relevant development on non-orthopaedic fields such as early diagnosis and … Exophytic means the cyst is bulging out of the ovary (most cysts do) and follicular cyst means that you are probably about to ovulate. A hemipelvectomy is a surgical procedure in which one leg and a portion of the pelvis are removed. Wide resection remains an important principle in the treatment of bone and soft tissue sarcomas. The ankle and subtalar joints were preserved. For patients who had external hemipelvectomy even the ability to sit upright can be difficult without a well-fitted sitting socket because of the lack of an ischium. Tertiary closure is reserved for the patients with healthy granulating wounds and extensive defects who are otherwise good operative candidates. See the Guidelines for Authors for a complete description of levels of evidence. Reconstruction after external hemipelvectomy using tibia-hindfoot rotationplasty with calcaneo-sacral fixation. Open Access This is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License ( However, it was the critical need for soft tissue reconstruction of the advanced decubiti and the infection of bony pelvis in paraplegic patients that led to increased utilization of the soft tissue obtained from high amputations. We aim to explore a reconstruction technique to improve function and post operative appearance for patients who undergo external hemipelvectomy. 1 Introduction; 2 Socket; 3 Suspension; 4 Prosthetic Components. Chan et al. Introduction. RESULTS: There were 31 standard, 62 modified, and 67 extended hemipelvectomy patients in whom 19 contiguous visceral, 62 spinal, 4 contralateral pelvic resections, and 1 contralateral hemipelvectomy … Pre-Operative MRI coronal view of Case Patient showing local cancer recurrence involving left pelvis and surrounding the saddle prosthesis. Because external hemipelvectomy resulted in major functional impairment, limb-sparing procedures removing part or all innominate bone with preservation of the extremity have been advocated. From posterior, the medial origin of the gluteus maximus was elevated from the sacrum. Karen Andrews. Case presentation We present a Case where extensive cancer involvement of pelvis and femur was managed with a novel surgical technique … Sacral resections are performed as a part of extended external hemipelvectomy for musculoskeletal sarcomas and, as such, reconstructed as a part of hemipelvectomy closure. Targeted muscle reinnervation following external hemipelvectomy or hip disarticulation: An anatomic description of technique and clinical case correlates. External hemipelvectomy is associated with high post operative morbidity and a poor functional outcome. Hemipelvectomy. Recently, an increasing number of patients with traumatic hemipelvectomy are admitted to trauma centers alive due to improvements of the pre-hospital care. Orthopaedics & Traumatology: Surgery & Research - Vol. Reconstructing complex open back wounds with a modified minimal-access keystone flap. published version (746.8Kb) Citations. Helping you find trustworthy answers on "Hemipelvectomy" | Latest evidence made easy CASE PRESENTATION: We present a Case where extensive cancer involvement of pelvis and femur was managed with a novel surgical technique … 1996, 3: 304-309. The internal aspect of the iliac muscle and the sacroiliac joint were dissected, thereby dividing the sacral plexus. Various techniques of resection and reconstruction give different functional scores. We prefer preoperative radiation for pelvic and retroperitoneal sarcomas. Along the medial thigh incision, the superficial femoral artery and vein were identified at the level of the adductor canal underneath the sartorius muscle and the vessels were skeletonized distally into the popliteal fossa keeping the blood supply to both heads of the gastrocnemius intact to for the basis of a filleted musculoskeletal calf flap. 1,2 The generally accepted oncologic principle of obtaining a wide margin is followed to ensure adequate tumor resection and to optimize local control. To repair the defect, a pedicled upper and lower leg in-continuity fillet flap with a total surface area of 1155 cm 2 was used, supplied by the external iliac vessels. Hemipelvectomy: Modified surgical technique and clinical experiences from a retrospective study Hemipelvectomy: Modified surgical technique and clinical experiences from a retrospective study Bray, Jonathan P. 2014-01-01 00:00:00 Objective To report a technique for hemipelvectomy surgery in the dog and cat. Introduction Difficult decision Reconstructive procedure. This technique is applicable in selected patient with unaffected external iliac and femoral vessels (i.e. This procedure is most commonly performed to treat oncologic conditions of the pelvis. A short summary of this paper. 10.1097/00003086-200109000-00022. The injuries sustained during the conflict in Afghanistan have transitioned from historically ballistic trauma to primarily blast induced, which has resulted in a greater incidence of bilateral lower extremity traumatic amputations with associated perineal, pelvic, an… By two months post op, patient was able to sit upright comfortably and ambulate with two crutches. Hemipelvectomy can be further classified as internal and external hemipelvectomy. Positioning: Type III resections involve the excision of a portion of the symphysis or the whole pubis from the pubic symphysis to the lateral margin of the obturator foramen. "left Hemipelvis" means "on the left side of the pelvis, like your left ovary". 94 Endovascular Repair of Abdominal Aortic Aneurysms. 1 Introduction; 2 Socket; 3 Suspension; 4 Prosthetic Components. Why? external hemipelvectomy. The major mixed motor and sensory nerve branches were identified, … Post operative 3D reconstruction of pelvis and neo-thigh. Original Editor - Tarina van der Stockt. International Seminars in Surgical Oncology Kong, G.Y., Rudiger, H.A., Ek, E.T. Author Kong, GY; Rudiger, HA; Ek, ET; Morrison, WA; Choong, PF. A CT of the pelvis is often useful to complement the MRI as this area is difficult to image. External hemipelvectomy is a procedure with considerable morbidity and is today only indicated for a small proportion of pelvic tumors, when the extent of the tumor and the involvement of the root of the thigh and the neurovascular bundle make it impossible to preserve the limb. Cadaveric dissections of multiple transpelvic exposures were performed. The tibia-hindfoot flap was then rotated such that the lateral aspect of the calcaneus came in contact with the ileosacral osteotomy. PubMed Other indications for hemipelvectomy include life-threatening infection and arterial insufficiency. Correspondence to PubMed Various modifications on the standard utilitarian approach have been used to best achieve these goals. J Surg Oncol. ), which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. © 2021 BioMed Central Ltd unless otherwise stated. PubMed Psychological issues surrounding body image following external hemipelvectomy is also significant and requires extensive pre and pos operative counseling [8]. hemipelvectomy”. This allows the patient to sit upright without the aid of a sitting socket. A 48-year-old T6 paraplegic man underwent external hemipelvectomy for osteomyelitis and an extensive Marjolin ulcer involving the buttocks, posterior thigh, and trochanteric regions. 2000, 8: 83-94. They infrequently metastasize and therefore local control becomes important. The reconstruction involves a modified anterior flap hemipelvectomy with resection of the femur and hemipelvis but preservation of below knee structures. This dog had a nerve root tumour travelling up the sciatic nerve. et al, 1994). Postoperatively, the patient remained non-weight bear on the neo-thigh. Patients should receive both antibiotic and mechanical bowel prep. Of these 24 cases, 13 did not have any reconstruction, 10 had a fibular graft and one had an iliacfemoral vein and artery prosthesis. The external, or classic, hemipelvectomy was the standard surgical procedure until the 1970s. The best position for these patients is the lithotomy or supine position. Currently, a paucity of data and lack of anatomical description exists regarding TMR in the setting of hemipelvectomy and/or hip disarticulations. 2. part of internal and external hemipelvectomy 3. pelvic fractures Technique 1. Improved survival of patients with musculo-skeletal malignancies, and refinements in surgical technique, have allowed the execution of limb-sparing procedures in these situations. When such pelvic resection involves removal of a part of the pelvis or sacrum, it is referred to as. Massive pelvic tumour is rarely encountered in our population but can be seen across all age groups and usually due to late presentation. statement and When embarking on treatment of pelvic sarcomas, three important questions should be borne in mind. What constitutes a resectable tumor without amputation varies among surgeons, and what constitutes an acceptable functional result varies among patients. In this study, the authors analyzed their experience with primary and secondary reconstruction of hemipelvectomy wounds. External hemipelvectomy denotes removal of the hemipelvis with affected lower extremity by disarticulation of the pubic symphysis and the sacroiliac joint. (Figure 1) No systemic recurrence was detected on chest CT, whole body Tc99-bone scan or Thallium scan. Is this tumor resectable, i.e., can this patient be rendered disease-free surgically? Material and methods: Seven patients were operated on at three specialty centers: six transpelvic amputations (external hemipelvectomy) and one hip disarticulation. 105 - N° 1 - p. 47-54 - Free fillet lower leg flap for coverage after hemipelvectomy or hip disarticulation - EM consulte The muscular flap, which is in continuity with the calf (superficial femoral and popliteal vessels and saphenous nerve intact), is then retracted anteriorly to allow adequate access to the hip and pelvis. Frey DMatthews LSBenjamin HFidler WJ A new technique for hemipelvectomy. Briefly, deep dissection commenced proximal to the iliac crest, where the abdominal wall musculature was divided. There are subtypes of the posterior flap hemipelvec-tomy (Figure 20.1C). Background: Although the technique of external hemipelvectomy has been adequately described, little is known about its complications and late results. Twenty-six surgeries were curative and six were palliative. 10.1097/00003086-200102000-00025. Clinical appearance of Case Patient 2 months following operation. Thieme E-Books & E-Journals. A total sacrectomy would be possible but is extremely mutilating. A skin incision was made from the lateral end of the popliteal crease parallel to the fibula down to the posterior aspect of the lateral malleolus. Three modifications of this classic technique aimed to decrease high wound complication rates: Incorporation of gluteal muscles in the hemipelvectomy flap, Whenever oncologically appropriate, ligation at the level of external iliac vessels with reservation of the internal iliac vessels to improve the flap blood supply, Limited resection of the bony pelvis that allows preservation of the sacral perforators, With these modifications, the posterior hemipelvectomy flap is designed as a musculocutaneous flap based on the superior and inferior gluteal vessels (, Long Anterior and Total Thigh Fillet Hemipelvectomy Flaps. Many of these patients were bound to years of ongoing wound care and immobility. Classic hemipelvectomy is a common procedure for the removal of large tumors in the location that cannot be removed by limb salvage surgery with an adequate margin. Secondary intention healing with wet-to-moist dressing changes and VAC® therapy is the most common approach to complicated hemipelvectomy wounds. The incidence of traumatic hemipelvectomy is rare, but it is a devastating injury. We aim to explore a reconstruction technique to improve function and post operative appearance for patients who undergo external hemipelvectomy. External hemipelvectomy is associated with high post operative morbidity and a poor functional outcome. Sneppen O, Johansen T, Heerfordt J, Dissing I, Petersen O: Hemipelvectomy. She represented to our unit 5 years following saddle-prosthesis surgery with local tumor recurrence within the pelvis and surrounding the prosthesis. The knee joint was then disarticulated and the patella resected. With the approval of our institutional review board, records of these 160 consecutive external … This principle was subsequently applied for coverage of the hemipelvectomy defects whereby a musculocutaneous flap of the anterior thigh compartment was elevated based on the superficial femoral artery. et al. Movement was allowed as a result of retained tibiotalar and subtalar joints. California Privacy Statement, Apffelstaedt JP, Driscoll DL, Spellman JE, Velez AF, Gibbs JF, Karakousis CP. Jump to:navigation, search. The treatment team must choose between pre- and postoperative radiation therapy. Wirbel RJ, Schulte M, Mutschler WE: Surgical treatment of pelvic sarcomas: oncologic and functional outcome. An external hemipelvectomy may be necessary in case of a tumor involvement of the neurovascular bundle but remains an exception for the primary tumor resection. PubMed Central Source Title Int Semin Surg Oncol. Acta Orthop Scand. The technique was further refined by Sugarbaker et al, who also demonstrated that the anterior flap can be used as a sensate island flap based on the superficial femoral vessels and saphenous nerve. Indian Journal of Plastic Surgery Full-text search Thorough preoperative assessment and planning, as well as considerations for defect closure options, are paramount to the success of the procedure. Amputations and Hemipelvectomy Yasser Alwabli. Similar tibial turn-up procedure to manage distal femoral bone loss has also been described in pediatric patients with good functional result [10, 11]. tumors was external hemipelvectomy (hindquarter amputation), but with advancements in surgical techniques and chemotherapy and radiation therapy, limb salvage procedures (internal hemipelvectomy) have also emerged as viable modalities [5]. The rotational tibia-hindfoot flap was supplied by the superficial femoral artery and vein. Although infrequently, pelvic and sacral resections are performed en bloc with pelvic visceral structures for locally advanced rectal and gynecologic malignancies eroding or invading the skeletal pelvis. Google Scholar. Peterson CA, Koch LD, Wood MB: Tibia-hindfoot osteomusculocutaneous rotationplasty with calcaneopelvic arthrodesis for extensive loss of bone from the proximal part of the femur. We aim to explore a reconstruction technique to improve function and post operative appearance for patients who undergo external hemipelvectomy. Technique. Omentum should be interposed between the intestine and hemipelvectomy flap whenever possible to wall off intra-abdominal contents in the event of hemipelvectomy flap necrosis. external hemipelvectomy is characterized by the concomitant amputation of the ipsilateral limb (Lopes . Surgery was completed with skin closure. Brachytherapy requires proper reconstruction planning so that flaps do not interfere with catheter placement (, Preoperatively, the patients with large pelvic tumor undergo mechanical bowel preparation and intravenous antibiotic coverage. Find all the evidence you need on "Hemipelvectomy" via the Trip Database. Hemipelvectomy is a major orthopedic surgical procedure indicated in specific situations and regularly performed in highly complex tertiary centers [ 1 , 2 ]. Original Editor - Tarina van der Stockt. We present a Case where extensive cancer involvement of pelvis and femur was managed with a novel surgical technique, which involved a calf sparing modified anterior flap hemipelvectomy combined with rotationplasty of the spared calf and fixation of calcaneus to the sacrum, thereby recreating a new thigh stump. We report on 2 patients who underwent type 3 internal hemipelvectomy. Tibia-hindfoot rotationplasty result in good functional outcome and appearance for selected patients undergoing external hemipelvectomy with unaffected external iliac and femoral vessels. Prior to surgical resection, patients should undergo local and systemic staging studies. Postoperative rehabilitation assessed on the basis of 41 cases. Hemipelvectomy, also known as a pelvic resection, is a surgical procedure that involves the removal of portion of the pelvic girdle. Peterson et al had previously described two cases of tibia-hindfoot rotationplasty with calcaneopelvic arthrodesis for infective complications involving the proximal femur. METHODS: The records of 160 consecutive hemipelvectomy patients were reviewed with a focus on demographics, treatment, and surgical techniques. 10.1007/BF02306287. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Ann Surg Oncol. Apffelstaedt JP, Driscoll DL, Spellman JE, Velez AF, Gibbs JF, Karakousis CP: Complications and outcome of external hemipelvectomy in the management of pelvic tumors. Secondary intention healing frequently resulted in protracted hospital course, extensive scarring, contractures, and unstable soft tissue coverage. Hemipelvectomy in dogs and cats is a viable treatment option for selected neoplastic and traumatic conditions. Anderson SR, Rako KM, Wimalawansa SM. External hemipelvectomy is one of the most inva- mors, infections, massive decubiti involving the pel- sive procedures in modern surgical practice. … 7,8 Since an adequate and tumor free resection margin is of great importance for the long-term oncological outcome, hemipelvectomy remains as a curative approach. The calcaneus tubercle functions as a neo-ischium and the tibia-hindfoot flap functions as a neo-thigh. The reconstruction involves a modified anterior flap hemipelvectomy with resection of the femur and hemipelvis but preservation of below knee structures. Purpose of Soft Tissue Flaps in Tumor Surgery, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), on Soft Tissue Coverage of the Pelvis and Sacrum: Hemipelvectomy and Pedicled Flap Coverage, Management of Soft Tissue Defects Surrounding the Knee and Tibia: The Gastrocnemius Muscle Flap, Allograft Prosthetic Composites in the Pelvis, Management of the Soft Tissue with Shoulder Trauma, Arthrodesis for the Chronically Infected Total Knee Arthroplasty, The Pedicled Soleus Muscle Flap for Coverage of the Middle and Distal Third of the Tibia, Master Techniques in Orthopaedic Surgery: Soft Tissue Surgery, Safe oncologic margins are the primary requirement, Reconstruction does not take precedence over adequate, safe resection, Adequate soft tissue coverage of bony reconstruction/prosthesis and neurovascular structures. Involvement of several surgical services such as urological, colorectal, vascular, spine, and plastic surgery is common. 1983, 197: 106-115. Standard long anterior flap hemipelvectomy includes the bulk of quadriceps femoris muscle (, Table 35-2. It is also a potential life-saving procedure for patients with massive pelvic trauma and uncontrollable sepsis of the lower limb. The Precise retrograde femoral nails were inserted based on the approved technique. Terms and Conditions, volume 5, Article number: 1 (2008)
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