Type 1 pelvic resection for chondrosarcoma

Discussion:

This patient underwent a type 1 pelvic resection for his chondrosarcoma.

Types 1-4 pelvic resections are an improvement on the older hemipelvectomy since they do not require resection of the ipsilateral lower limb. This, however, presents a biomechanical challenge as the incomplete pelvis is unstable and the line of force from the upper body to the lower limb is now directed around a weaker pubic ramus, which is torqued around the contralateral pelvis.

In order to give the pelvis some biomechanical strength, osseous allografts or arthroplasty hardware may be used to bridge the gap. In this case, a resected humeral head allograft completes the pelvic ring.

If the resection of the iliac wing is small/partial, some orthopedic surgeons may try to close the pelvis by wiring the two resection margins of the pelvis together and accepting a leg-length discrepancy.

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