Abstract
Pelvic resection in limb salvage surgery always pose a major challenge for orthopedic surgeon, especially in large tumor extension that requires combination of pelvic and femoral resection with sacrificing the hip joint. Complex anatomy and preservation major structure (arteries, veins, nerves, muscle and visceral organs) is a major consideration.
Methods:
We evaluated the oncologic, functional outcome and complications of a patient 27 years old with Ewing sarcoma involving the left pelvis (ilium, ischium and pubic) and femoral proximal until middle third, who underwent pelvic resection type II, III involving hip joint with femoral resection. The reconstruction that has been done were: hip transposition using cemented scaffold and modified Harrington as framework, proximal femoral megaprosthesis, capsuloplasty using polypropylene mesh and reattachment of muscles around the hip.
Results:
Follow-up at 3 months showed a good oncological and tolerable function outcome; by means of no local recurrence or distant metastatic with painless partial weight bearing. Active motion of the hip is preserved with muscle power of 4/5 and LLD of 3 cm. The patient were able to ambulate by himself, sitting in normal position with no pain. There were no major complications were found in this patient such as infection, dislocation, loosening implant or visceral complications.
Conclusion:
The choice of limb salvage in pelvic tumor followed with complex reconstruction of the hip still amenable in patient with malignant tumor of pelvic and femur, regarding the oncological, functional outcome and complication.