Definition:

Sarcoma is a type of malignant tumor of bone and soft tissue which if left untreated will cause death. Limb Sparing Surgery is surgical entity where the upper limbs or lower limbs are being preserved instead being amputated due to a disease process such as cancer, trauma or a severe nerve injury. The aim is to maintain the limbs and its function without effecting the outcome of the disease.

Signs and Symptoms :

Usually the patient is not aware of the disease that he/she is suffering. In some of these patient, it is a silent disease causing unnoticed swelling in the body affected. Other sign of bone cancer is pain especially at night. The pain is progressive and not control by normal ‘pain killer’. Bone cancer may lead to fractures as it infiltrates and weaken the bones and finally they were loss function of the limb. In advanced cases, the cancer can grow very large and the patient begin to show lost weight and become cachectic. In such situation amputation is a treatment of choice.

Causes and Diagnosis :

The cause of bone cancer is unknown. Probably, they could be a genetic defect whereby there are errors in the DNA cells that grow and divide in a way that is not controlled. It is well-known that exposure to radiation can produce to many types of cancer. This can be the cause of bone cancer.

After initial examination through physical assessment, the patient needs to undergo certain laboratory tests and radiology tests; X-Ray, Magnetic Resonance Imaging (MRI), CT-Scan, bone scan and finally bone biopsy to confirm the nature of the disease.

Care and Treatment:

Certain Sarcoma are treated initially with chemotherapy before it is subjected to surgical known as resection of tumor and reconstruction of the limb.

We operated on the patient with the intent of sparing the limb. Cancer were removed totally and it is replace with large prosthesis or bone graft were inserted to replace the excised cancer. The associated joint were either preserve or reconstructed with prosthesis.

Sometimes, the Plastic Surgeon is called to close the wound that have been removed together with the cancer.

Rehabilitation of these patient is time consuming so as to train the patient to get back the limb function, building the muscle and strengthening the limb. Moreover, it also to improve or maintain the range motion of the joints.

Regular follow up for several years is advisable after treatment since complications on recurrent of the tumor should be detected early.

Prognosis :

Some bone cancer are treatable and patient can be cured. Most cancer can be control. Early detection able to save your life. Get yourself to be assessed especially will looking at whether the cancer is in other body or bone tissues.

Limb Sparing Surgery
Prof Dr. Zulmi Wan
Consultant Orthopaedic Surgeon
Prince Court Medical Centre

Prof. Dr. Zulmi Wan