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Limb salvage: When, where, and how?

From an era where amputation was the only option to the current day function preserving resections and complex reconstructions has been a major advance in the treatment of musculoskeletal sarcomas. The objectives of extremity reconstruction after oncologic resection include providing skeletal stabil...

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Autor principal: Puri, Ajay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4292326/
https://www.ncbi.nlm.nih.gov/pubmed/25593356
http://dx.doi.org/10.4103/0019-5413.143912
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author Puri, Ajay
author_facet Puri, Ajay
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description From an era where amputation was the only option to the current day function preserving resections and complex reconstructions has been a major advance in the treatment of musculoskeletal sarcomas. The objectives of extremity reconstruction after oncologic resection include providing skeletal stability where necessary, adequate wound coverage to allow early subsequent adjuvant therapy, optimising the aesthetic outcome and preservation of functional capability with early return to function. This article highlights the concepts of surgical margins in oncology, discusses the principles governing safe surgical resection in these tumors and summarises the current modalities and recent developments relevant to reconstruction after limb salvage. The rationale of choice of a particular resection modality and the unique challenges of reconstruction in skeletally immature individuals are also discussed. Striking the right balance between adequate resection, while yet retaining or reconstructing tissue for acceptable function and cosmesis is a difficult task. Complications are not uncommon and patients and their families need to be counseled regarding the potential setbacks that may occur in the course of their eventual road to recovery, Limb salvage entails a well orchestrated effort involving various specialties and better outcomes are likely to be achieved with centralization of expertise at regional centers.
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spelling pubmed-42923262015-01-15 Limb salvage: When, where, and how? Puri, Ajay Indian J Orthop Symposium-ICL-2014 From an era where amputation was the only option to the current day function preserving resections and complex reconstructions has been a major advance in the treatment of musculoskeletal sarcomas. The objectives of extremity reconstruction after oncologic resection include providing skeletal stability where necessary, adequate wound coverage to allow early subsequent adjuvant therapy, optimising the aesthetic outcome and preservation of functional capability with early return to function. This article highlights the concepts of surgical margins in oncology, discusses the principles governing safe surgical resection in these tumors and summarises the current modalities and recent developments relevant to reconstruction after limb salvage. The rationale of choice of a particular resection modality and the unique challenges of reconstruction in skeletally immature individuals are also discussed. Striking the right balance between adequate resection, while yet retaining or reconstructing tissue for acceptable function and cosmesis is a difficult task. Complications are not uncommon and patients and their families need to be counseled regarding the potential setbacks that may occur in the course of their eventual road to recovery, Limb salvage entails a well orchestrated effort involving various specialties and better outcomes are likely to be achieved with centralization of expertise at regional centers. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4292326/ /pubmed/25593356 http://dx.doi.org/10.4103/0019-5413.143912 Text en Copyright: © Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Symposium-ICL-2014
Puri, Ajay
Limb salvage: When, where, and how?
title Limb salvage: When, where, and how?
title_full Limb salvage: When, where, and how?
title_fullStr Limb salvage: When, where, and how?
title_full_unstemmed Limb salvage: When, where, and how?
title_short Limb salvage: When, where, and how?
title_sort limb salvage: when, where, and how?
topic Symposium-ICL-2014
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4292326/
https://www.ncbi.nlm.nih.gov/pubmed/25593356
http://dx.doi.org/10.4103/0019-5413.143912
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