Options of limb-salvage surgery for late presenting or large malignant bone tumors

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Lack of education, coupled with apathy, socioeconomic conditions, the need to travel vast geographical distances to access health care, reliance on alternate medical practices, and a shortage of trained orthopaedic oncologists all contribute to late presentations of malignant bone tumors in the developing world. Balancing the two opposing goals of ensuring adequate resection of involved bone and soft tissue so as to minimize the chance of local recurrence while yet preserving adequate function of the limb after reconstruction often can be a challenge, especially in patients with large tumors. In a resource-challenged setting, the ingenuity of the treating team often is tested when deciding on reconstruction modalities, resulting in more inexpensive and locally applicable solutions for limb salvage as compared with conventional modalities. This article seeks to illustrate some such options for limb salvage in late presenting or large malignant bone tumors.

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