Abstract

Background / Objective: Proximal disarticulations and amputations remain necessary for selected cases of locally advanced extremity tumors. We describe a modified technique combining suspended limb positioning, simultaneous two-team dissection, and asynchronous vascular ligation, and report outcomes from an initial case series. Methods: Retrospective case series at a single orthopedic oncology referral center including all consecutive patients who underwent the described procedure between 1999 and 2020. Demographic, histologic and perioperative data were collected. The study was approved by the institutional ethics committee (Opinion No. 7.316.148). Results: Eighteen patients were included (11 males, 7 females; mean age 54.4 years, range 13–92). Most common diagnoses were chondrosarcoma (n=7), pleomorphic sarcoma (n=4) and osteosarcoma (n=3). All patients survived at least 30 days postoperatively. The technique was feasible and safe in this series; the combined strategy appeared to improve surgical exposure and hemostatic control, in line with existing reports. Conclusions: Suspended limb positioning with a simultaneous two-team approach and asynchronous vascular ligation is a safe, reproducible, and ergonomically advantageous method for proximal amputations in orthopedic oncology, with potential to optimize operative time and blood loss. Prospective comparative studies are warranted to validate these findings

Keywords

hip disarticulation, proximal amputation, limb suspension, asynchronous vascular ligation, orthopedic oncology, surgical technique