Complications Of Limb Salvage

Bone and soft tissue sarcomas represent only about 2% of all malignancies; however, their treatment – with the goal of curing the patient while preserving the functionality of the affected body part – can, unlike other malignancies, only be successful with therapy concepts devised by interdisciplinary teams. This volume provides an extensive up-to-date overview of the specific diagnostics and current treatment standards of these rare entities, presenting the various limb-sparing modalities for patients with bone and soft tissue sarcomas with special regard to innovative reconstructive options. The evaluation of quality of life based on validated scores and the individual methods of coping with the illness through creative artistic projects are also acknowledged and integrated in the whole concept.

An international group ofresearchers has met every 2 years since 1981 to examine the progress made in limb salvage techniques and the perspectives of this field of surgery. In 1989 the Fifth International Symposium On Limb Salvage (ISOLS) was held in Saint Malo and was attended by more than 300 participants from 34 different countries. The 105 papers presented, grouped under eleven main headings, have been included in this book. Limb salvage has indeed progressed in the years since the first symposium. Initially it essentially concerned tumours and the main aim was to salvage the diseased limb through non-mutilating surgery without jeopardizing the patient's prospects of survival. Now, with a confirmed high rate of 5-year disease-free survival, new goals can be set: improvement of the functional results and of the survival of our reconstructions. How can this be achieved: - By favouring muscle reattachment on the prosthesis, for instance through the use of a bone allograft-sleeved composite prosthesis? - By improving the survival of the arthroplasty through the develop ment of a more biological fixation of its stems? - By limiting the side effects of the necessary adjuvant treatments on the function of the allograft as well as on the fixation of the prosthesis? In addition, limb salvage procedures now concern not only primary tumours (and metastases, which must be treated using the same osteosynthetic and prosthetic techniques), but also reconstructive orthopaedic surgery as a whole.

Steven A. Rosenberg, MD In the past two decades significant progress has quality of life. The use of local radiation therapy has occurred, in the management of patients with mus- had a profound impact on the ability to achieve local loskeletal cancers, that has improved both the survival control. Cooperation between surgeons and radiation and the quality of life of afflicted patients. Changes in therapists often results in the tailoring of surgical p- the management of these patients have mirrored cedures to maximize the combined application of these trends in the entire field of oncology. two effective treatment modalities. Although impact on The most significant change has been improvement overall survival has not been demonstrated due to the in the surgical techniques for the resection of musculo- addition of radiation therapy, important advances in skeletal cancers based on a detailed understanding of improving the quality of life of patients receiving this the anatomic features of each particular tumor site, as combined-modality treatment have been evident. well as an appreciation of the natural biology that affects A third change impacting on the survival of patients the local spread of these tumors. The current volume of with musculoskeletal cancers has been the aggressive Musculoskeletal Cancer Surgery: Treatment of Sarcomas and resection of metastatic deposits.

Standards for the Management of Open Fractures provides an evidence-based approach for the management of open fractures, focussing on lower limb injuries. It builds on and expands the NICE Guidelines to provide a practical approach with supporting evidence. The new edition has been extensively updated and expanded to include key aspects of management, ranging from setting up an orthoplastic service, through to dealing with the bone and soft tissue injures, complications such as infection, and patient rehabilitation and psychological care. The book is primarily aimed at trainee plastic, orthopaedic and trauma surgeons (particularly for expanding knowledge and examination revision) but would also appeal to established surgeons to improve patient care. Standards for the Management of Open Fractures is an open access title. It is available to read and download as a free PDF version on Oxford Medicine Online. It has been made available under a Creative Commons Attribution-Non Commercial No Derivatives 4.0 International licence.