Limb salvage surgery, also known as reconstructive surgery, is a procedure aimed at repairing and restoring a critically diseased or injured limb to avoid amputation. The goal of this surgery is to reinstate functioning, improve the person’s quality of life, and prevent the complications associated with amputation. It often involves a combination of orthopedic and plastic surgical skills to restore both the functioning and appearance of affected limbs.
These injuries can be severe and may lead to new infections or other complications, including damage that separates skin and muscle from bone, as well as certain fractures that compromise soft tissues and blood supply to the affected areas. Reconstructive surgery may be used to treat injuries caused by physical trauma from an accident, frostbite, or cancer.
Limb salvage operations are defined as those that offer tumor control without sacrificing the limb. The majority of musculoskeletal surgical treatments result in limb salvage, including intralesional excision, marginal excision, and the majority of wide excision. This means that not only the musculoskeletal structures but also the neurovascular structures, must be viable or restored.
Conditions that limb salvage surgery can treat:
This limb salvage surgery can be an option if a person is suffering from bone cancer or soft tissue sarcoma in an arm or leg. This is on the doctor, depending on the severity of the injury, if they can remove the cancerous tumor without sacrificing the affected limb. Salvage refers to repairing, and reconstructing different parts. This is a common treatment for certain conditions such as;
- Types of bone sarcomas include osteosarcoma, Ewing sarcoma, and chondrosarcoma.
- Soft tissue sarcomas include liposarcoma, myxofibrosarcoma, and leiomyosarcoma.
- Other conditions such as metastatic bone cancer, severe bone infections (osteomyelitis), joint infections (septic arthritis), and soft tissue infections (gangrene).
- traumatic injuries can also cause bone-related issues.
Limb salvage and reconstructive involve multiple surgeries, the surgeons have to reconnect, repair, or replace the blood vessels, nerves, bones, and other tissues. This might involve;
- Revascularization involves restoring the lost blood flow to a limb through vascular surgery techniques.
- Microsurgery may be necessary to replace damaged vascular or nerve tissue with tissue from a donor or the patient's own body, connecting the blood vessels or nerves.
- Grafting may involve using a bone graft or skin graft from a donor or the patient's own body to replace a damaged or missing part of the limb.
- Prosthesis involves using metal implants to replace or repair a bone or joint, restoring the functionality of the limb. In some cases, prosthetics may combine metal with a bone graft.
- Bone transport may involve using a stainless-steel fixator system to fill in or lengthen long bones, stimulating bone growth.
Diagnostic procedures
Before limb salvage surgery, doctors may suggest taking medications to stabilize the condition. In the case of cancer, chemotherapy or radiation therapy may be recommended to shrink the tumor before surgery. Various tests, including imaging tests like MRI and CT scans, may also be suggested to diagnose the condition.
Advantages and disadvantages of getting a limb salvage surgery
Advantages include;
- You might experience a normal physical experience as before.
- Equal and better quality of life and survival rate.
Disadvantages include;
- Longer rehabilitation
- Salvages limbs may need more follow-up care
- Higher likelihood of needing revision surgeries
Risk factors include;
- Infection
- Wound healing complications
- Failure of the surgery and the need to amputate
- Complications and prosthetics, which might break or loosen
- Disease or condition that left your limb, might attack back