Limb-Sparing Surgery A Godsend For Children

The thought of anyone losing a limb is heart-wrenching. The thought of a child or a teen losing an arm or leg is even more so if for no other reason other than their lives will be so inextricably altered so early in life. Losing a limb is no less traumatic for everyone else too, especially those brave men and women in our military, who put life and limb on the line everyday in the defense of our country. That said, those who are at risk of losing a limb to disease rather than traumatic injury may find some hope in new limb-sparing surgical techniques that are being developed, especially when treating malignant bone tumors. Unlike many other surgical procedures used to treat these tumors in children, limb-sparing surgery, for the first time, gives your child a great chance of keeping his or her limb while treating the tumor.

Limb- Sparing Surgery: Giving Kids Hope

Malignant tumors can spread through the body quickly, quietly, and with deadly consequences. More often than not, doctors will treat a malignant tumor by removing it when possible, and in cases where those tumors are located in the leg, a surgeon is likely to remove the patient’s leg while removing the tumor to ensure that it doesn’t spread into other parts of the body, especially vital organs. The surgery, even when successful in ridding the patient of cancer, can leave a young child in traumatized state for quite sometime as he or she contemplates how to go about living life with one leg. New surgical techniques being developed by cancer surgeons have led to advances in those operations where they are able to remove only the tumor and surrounding bone and cartilage while leaving the rest of the leg intact.

 

The parts of the leg bone that were removed during surgery are eventually replaced using bone transplants, or allograft bones grafts, or metal implants similar to those used in knee joint replacements. Even in young children, who still have a great deal of body and bone growth ahead of them are able to have limb-sparing surgery with the help of a recently developed device called a growing prosthesis that expands while inside the child’s limb.

 

Related Medical Advances a Great Help

In order to see if a child is a candidate for limb-sparing surgery a team of doctors will evaluate the case on the basis of several factors, many of which are determined with the assistance of advanced medical technologies that help to ensure that the final decision is the right one. First on the list are the images that a doctor will take of the tumor. Over the course of time these images will help the surgeon decide if the tumor is growing, where exactly it is located as well as providing images to help with a surgical plan of attach so to speak. The Doctor’s at Children’s Hospital were pioneers in developing the PET scan and the MRI, both of which are vital in providing detailed images of malignant tumors. A PET scan, or Positron Emission Tomography, is a test that produces three-dimensional images that can help doctors discern cancerous tumors from healthy tissue as well as helping them to see how well treatments are working at reducing the size of the tumor.

The use of these images after chemotherapy helps the surgeon to see if the tumor is shrinking to a size where it will be operable, and most importantly, will be able to be removed without removing the child’s leg. These images are also vital in post-surgical procedures in evaluating how bone grafts are healing as the child grows.

Candidates for Limb-Sparing Surgery

Those children with osteosarcoma and Ewing sarcoma are the prime candidates for limb-sparing surgery but there are still many factors that will determine if this surgical technique is the right one for them. Their doctor will want to see the size of the tumor, the location, and the degree to which it has spread before making an evaluation about being able to use limb-sparing surgery in treating your child’s tumor. If a tumor is too close to a major artery or nerve limb-sparing surgery may not be an option for them. Doctors will also want to see the tumor respond to chemotherapy to shrink the mass also before making any decision. One other factor is the amount of soft tissue in the leg. Doctors will want to make sure that your child has enough soft tissue in the surrounding area to be confident that the wounds will heal properly after the surgery.

Post-Op

Any surgery is major if you are the one having the surgery and while limb-sparing surgery is a Godsend in ridding your child of a cancerous tumor while also saving his or her limb, it is still quite a traumatic operation and the recovery can be long and difficult. One of the most challenging parts of this surgical technique is matching the implant that is placed in the leg to your growing child. In some cases a child will need several procedures that lengthen the implants to keep up with the normal growth of the child. However, compared to the alternatives, most families will take it everyday and twice on Sunday.

 

 

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