Muhammad Saeed Minhas, Irfan Ullah Insari, Ghulam Mehboob.
Internal hemipelvectomy with limb preservation early experience at a tertiary care hospital in Pakistan.
J Pak Orthop Assoc Jan ;24(1):1-8.

Objectives: To evaluate Clinico Pathological presentation of primary pelvic bone tumours and determine the technical feasibility of excising the hemipelvis, ilium, ischium or pubis along with involved sacrum and proximal femoral head, without endoprosthetic reconstruction and preserving a functionally intact lower limb. Place and Duration of Study: Jinnah Post Graduate Medical Centre Karachi January 2003 to January 2009. Study Design: Descriptive study. Patients and Methods: Seventeen patients reported in Orthopaedic department of JPMC in last six years with pelvic bone tumours, their clinical information and radiographic features are analyzed. Imaging studies were done, establishing diagnosis and selecting patients for internal hemipelvectomy. Only eight cases of primary pelvic bone tumours fulfilled the criteria of Partial or hemi- internal pelvectomy, which were performed and follow up of the patients were studied. Results: Eight patients operated for pelvic bone tumours, with mean age of 29.9 ± 9.9 years, six were male and two female. The relative frequency of different tumours were, Chondrosarcoma (4) 50% Osteosarcoma (1) 12.5%, Ewings sarcoma (2) 25%, Giant cell tumour (1) 12.5%. The common presenting symptoms were pain, palpable mass and weight loss. The relative frequency of the different bone involvement were found as iliac bone (04) 50%, periacetabular (02) 25%, ischium (01) 12.5% and pubic bone (1) 12.5%. Wide margin resection was achieved in six cases. Morbidity of the surgery was infection in one case, flap margin necrosis and wound hematoma in one patient and mortality during hospital stay was one due to secondary haemorrhage. The overall complication rate in this series is 50%. Conclusion: Pelvic bone tumours are rare and complex. Primary bone tumours presents in younger age and with advance stage because of capacious pelvic cavity.Every young patient with pelvic pain should be examined clinically and radio logically with suspicion of pelvic tumours for early diagnosis of pelvic bone tumour. Multidisciplinary approach should be adopted to diagnose and treat pelvic bone tumours. Internal hemipelvectomy with retaining lower limb provides better functional results in selected cases.

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