Guidelines for Complications of Cancer Treatment Vol VIII Part B

Complications After Limb SalvageSurgery : Evidence Based GuidelinesAbstractLimb Salvage Surgery has become a standard of care even indeveloping nations like India. Endoprosthetic reconstruction,allografts, rotationplasty or autografting are the commonlyused reconstructive methods. Prosthesis are commonly useddue to immediate stability and mobility and the excellentcosmesis and function. Some complications are encounteredwith other modality of limb salvage procedure, whereas theothers are endoprosthetic-unique. Expectedly, there is anincreased incidence of complications compared to a routineorthopaedic operation, especially in the long term survivors.The major causes of such a relatively high rate of complicationsinclude (1) extensive excision of soft tissue, leading to changeof biomechanical ergonomics, little soft tissue constraints orsupport for a long replacement segments, and decreased localdefence to infection, (2) increased stress on the implants dueto higher activity level in the youthful active individuals,relatively narrower medullary canals with less cancellous bonefor fixation, (3) special needs for the stability resulting an97