Hemipelvectomy
Hemipelvectomy | |
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Other names | Hindquarter amputation, pelvic resection |
Specialty | Orthopedic surgery |
Hemipelvectomy, also known as a pelvic resection, is a surgical procedure that involves the removal of part of the
Medical uses
Hemipelvectomy is generally reserved for the treatment of pelvic
Complications
As with any surgical procedure, risks include infection, blood loss, damage to surrounding structures, cardiac/pulmonary complications, and adverse reactions to anesthesia.
Complications of external hemipelvectomy include:[1][2]
- Disfigurement
- Loss of ambulation
- Phantom limb pain
- Bladder dysfunction
- Sexual dysfunction
- Bowel dysfunction
Complications of internal hemipelvectomy include:[1][2]
- Leg-length discrepancy
- 'Flail hip' or 'floating hip' (referring to hypermobility of the hip joint)
- Hip instability
Technique
Prior to performing a hemipelvectomy, surgeons must possess detailed knowledge of the pelvic anatomy and its relation to the pelvic tumor.
The Enneking and Dunham classification system was developed in 1978 to aid surgeons in characterizing pelvic resections.[1][3][4] This classification scheme breaks down pelvic resections into 3 subtypes: Type I, Type II, and Type III.[1][3][4] Type I resections involve removal of the ilium.[1][3][4] Type II resections involve removal of the peri-acetabular region.[1][3][4] Type III resections involve removal of the ischial and/or pubic region.[1][3]
Resection of pelvic bone typically requires subsequent reconstruction to ensure stability of the hip joint, particularly in internal hemipelvectomy.
Additional images
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An x-ray of a limb-sparing hemipelvectomy on the left side of a male pelvis taken one month after surgery.
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An x-ray of the same pelvis taken eighteen months after surgery highlighting the femur migration to its final resting place.