Limb-salvage surgery is to remove a tumor in your leg without removing the whole limb. It is also referred to as lower limb reconstruction to help the legs to bear the body weight and be responsible for walking. The surgeon might also remove the bone and tissue around the tumor and use an implant to replace part of the limb. This surgery saves the appearance and the functionality of the leg. Limb salvage is an option for children with malignant tumors either on the arm or leg. Other conditions that can afflict limb-sparing techniques include stump salvage, trauma, chronic infections, exposed prosthesis, foot ulcers, among others.
Types of implants used during Limb-sparing techniques
Expandable prosthesis – It is a new option for middle stage children. With growth, a child’s limb lengthening is expected. So, with a prosthesis, a strong magnet is used to extend the tube with small increments as the limbs continue to grow. The technology is suitable for children most likely to grow two centimeters of the limbs in length. It is suitable for girls of 8 to 12 in age and boys of 8 to 14.
The implant may not be set properly if the child is too young. Depending on how much the bone is being replaced, the prostheses can only extend to a certain length. If the child is almost fully grown, the traditional nonexpanding rod may be used. If the limb is shorter, use shoe inserts to compensate for the leg length.
Endoprostheses – It is a metal implant used to replace the bone but it cannot be lengthened. It can be used on fully grown teens and young adults. The surgeon implants a slightly longer endoprosthesis so that the two limbs may be almost the same length after growth.
Allograft bone replacement – An implant of a bone from an organ donor is used to replace the bone affected around the tumor. An allograft bone replacement like the endoprostheses does not grow or change in size. The surgeon implants a longer bone to compensate for expected future growth.
Limb-salvage and chemotherapy
Tumors respond well to chemotherapy used before the patient undergoes limb-salvage surgery. When the tumor shrinks, the surgeon can save some tissues. Chemotherapy causes slow growth in a child and they start growing after their treatment. Chemotherapy uses medications to stop the growth of cancer cells and the treatment starts immediately after the malignant tumor has been diagnosed. Limb-salvage surgery may stop the growth of the affected limb depending on how close the tumor is to the growth plates and the size of a tumor. Limb surgery takes a longer time to heal if the patient continues with chemotherapy after surgery. It may take up to one year for a patient to fully function without crutches after the procedure.
Limb-salvage surgery considerations
The suitability of the surgery depends on the age of a child and their stage of development. The size and location of the tumor are similarly considered. When the tumor is large and has spread to the knee, amputation is considered. The surgery allows a child to keep a full limb that looks much like the other healthy limb. After recovery, the limp can be used for low-impact activities such as riding a bike, swimming, and walking.