Citation Information :
Mohammed R, Baloch K, Peart F, Abudu A. Functional salvage of a mangled lower limb using custom-made endoprosthetic replacement. 2009; 4 (3):145-149.
Functional salvage of a severely injured extremity is a challenge for the patient and the treating surgeon. We report a case of a woman presenting with severely injured lower limb and bone loss, which was managed using a custom-made endoprosthetic replacement for successful functional outcome. Despite being complicated by bone loss, nerve injury and infection; a planned staged surgical treatment and rehabilitation have resulted in satisfactory outcome. At 3-year follow-up, the functional score according to the Musculoskeletal Tumor Society-International Symposium on Limb Salvage System was 70% and the Toronto Extremity Salvage Score was 62%. Endoprosthetic replacements may have a limited role in managing selected patients with mangled extremity and can lead to a good functional outcome to these patients.
Enneking WF, Dunham W, Gebhardt MC, Malawer M, Pritchard DJ (1993) A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop 286:241-246
Davis AM, Wright JG, Williams JI, Bombardier C, Griffin A, Bell RS (1996) Development of a measure of physical function for patients with bone and soft tissue sarcoma. Qual Life Res 5(5):508-516
Bosse MJ, MacKenzie EJ, Kellam JF, Burgess AR, Webb LX, Swiontkowski MF, Sanders RW, Jones AL, McAndrew MP, Patterson BM, McCarthy ML, Cyril JK (2001) A prospective evaluation of the clinical utility of the lower-extremity injuryseverity scores. J Bone Joint Surg [Am] 83-A:3-14
Helfet DL, Howey T, Sanders R, Johansen K (1990) Limb salvage versus amputation: preliminary results of the mangled extremity severity score. Clin Orthop Relat Res 256:80-86
Lerner A, Fodo L, Soudry M, Peled IJ, Herer D, Ullmann Y (2004) Acute shortening: modular treatment modality for severe combined bone and soft tissue loss of the extremities. J Trauma 57(3):603-608
Saleh M, Rees A (1995) Bifocal surgery for deformity and bone loss after lower-limb fractures: comparison of bone-transport and compression-distraction methods. J Bone Joint Surg [Br] 77-B:429-434
Mekhail A, Abraham E, Gruber B, Gonzalez M (2004) Bone transport in the management of posttraumatic bone defects in the lower extremity. J Trauma 56(2):368-378
Beaver RJ, Mahomed M, Backstein D, Davis A, Zukor DJ, Gross AE (1992) Fresh osteochondral allografts for post-traumatic defects in the knee: a survivorship analysis. J Bone Joint Surg [Br] 74-B:105-110
Salai M, Horoszowski H, Pritsch M, Amit Y (1999) Primary reconstruction of traumatic bony defects using allografts. Arch Orthop Trauma Surg 119:435-439
Allende C, Allende BT (2004) Posttraumatic one-bone forearm reconstruction: a report of seven cases. J Bone Joint Surg [Am] 86-A:364-369
Myers GJ, Abudu AT, Carter SR, Tillman RM, Grimer RJ (2007) Endoprosthetic replacement of the distal femur for bone tumours: long-term results. J Bone Joint Surg [Br] 89(4):521-526
Freedman EL, Eckardt JJ (1997) A modular endoprosthetic system for tumor and non-tumor reconstruction: preliminary experience. Orthopedics 20(1):27-36
Grimer RJ, Carter SR, Tillman RM, Sneath RS, Walker PS, Unwin PS, Shewell PC (1999) Endoprosthetic replacement of the proximal tibia. J Bone Joint Surg [Br] 81(3):488-494
Unwin PS, Cobb JP, Walker PS (1993) Distal femoral arthroplasty using custom-made prostheses: the first 218 cases. J Arthroplasty 8(3):259-268
Bradish CF, Kemp HB, Scales JT, Wilson JN (1987) Distal femoral replacement by custom-made prostheses: clinical follow-up and survivorship analysis. J Bone Joint Surg [Br] 69(2):276-284
