Browsing by Subject "amputation"

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    Modular prosthetic reconstruction for primary bone tumours of the distal tibia in ten patients
    (2022) Mugla, Walid; Hilton, Thomas
    Introduction: Below knee amputation is the safest treatment for aggressive benign and malignant bone tumours of the distal tibia yielding good oncological and functional results. However, in selected patients where limb salvage is feasible and amputation unacceptable to the patient, limb salvage using a distal tibial replacement (DTR) can be considered. This study aims to present the oncological and functional results of the use of this treatment method in our unit. Patients & Methods: A retrospective folder review was performed for all 10 patients who received a modular distal tibial replacement between 01/01/2005 and 31/01/2019 for a primary bone tumour either benign aggressive or malignant. Six were female and the mean age was 31 (1275) years. There were five patients with giant cell tumour of bone, four with osteosarcoma and one with a low-grade chondrosarcoma. The patients with osteosarcoma had neo-adjuvant chemotherapy before surgery. Function was assessed by the Musculoskeletal Tumor Society (MSTS) score. Results: There were six females and four males, with a mean age of 31 (12-75) years. Two patients had local recurrence treated with a BKA and one other patient died of metastases three years postoperatively. At a mean follow-up of three years, the remaining eight patients had a mean MSTS score of 83% (67–93%). There were no radiological signs of loosening, and no revision surgeries. Conclusion: Endoprosthetic replacement of the distal tibia for primary bone tumours can be a safe treatment option in very selected cases.
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    Open Access
    Use of a tourniquet in lower limb amputations: Evaluating blood loss in peripheral arterial disease patients A systematic review
    (2022) Eldurssi, Omar; Kloppers, Jacobus Christo
    Background: Tourniquets have become an inseparable part of many different types of intricate and major surgeries, including amputation. Tourniquets create a bloodless environment, which is thought to facilitate surgery and reduce time, potential errors and subsequent complications. Objectives: To investigate the effectiveness of using a pneumatic tourniquet as an adjunct in lower limbs amputation in peripheral arterial disease to reduce blood loss and requirement for blood transfusions. Stump revision rate, complication and mortality will be assessed as secondary objectives. Method: For this systematic review, a search was performed using the keywords phrases, “peripheral arterial disease”, “lower limb amputation” and “tourniquet” in PubMed, Medline, Embase and Google scholar. Results: Based on univariate analysis, to determine the relationship between risk factors and blood loss, the study demonstrated the use of tourniquet significantly reduces the amount of blood loss during lower limb amputation (LLA), F (21.01), P=0.044. An independent t -test, demonstrated that there was a statistically significant difference in mean blood loss between tourniquet and non-tourniquet studies, (T=-2.588, P=0.049). In this review the mean blood loss was 251.67±2.89 and 462.5±137.69ml for tourniquet and non-tourniquet studies respectively. Conclusion: Using a tourniquet is a technically feasible approach to LLA, and effectively reduces the amount of blood loss and requirements of blood transfusion. No change in revision rates were noted.