Limb Salvage Surgery

What is limb salvage surgery? 

Limb salvage surgery keeps a limb in the best and most functional way possible when a child is at risk of losing it due to trauma, tumor, infection or other conditions. While each limb salvage surgery may be different, our team uses state-of-the-art technology to evaluate and plan your child’s surgery, using MRI, CT scans, 3D printed guides and other measurements.

What are the types of limb salvage surgery?

At Children’s Hospital Colorado, we provide surgery that allows children to live their lives to the fullest. We have several treatment options:

• Limb salvage with endoprosthetics: An endoprosthetic is a large, custom metal implant that replaces the bone that surgeons remove when they take out a cancerous tumor. We can provide expandable versions that grow with your child to make their limbs as equal as possible.
• Limb salvage surgery with intercalary bone allografts: Depending on the location of the tumor or sarcoma, this procedure removes the cancerous tumor while preserving the nearby joint and often, the growth plate. Our surgeons replace the bone with a bone graft (transplanted bone or bone tissue) from another person.
• Limb salvage surgery with bone transport: An option after sarcoma removal, this procedure removes a section of damaged bone and then slowly moves the child’s bone to reconnect where surgeons cut the bone. Removing the sarcoma creates a gap in the bone. Surgeons then attach special nails and other devices to bridge that gap and keep the bone’s function while the gap heals. Surgeons then slowly move the bone over time to close the gap and with the help of special implants, new bone grows where the bone has moved from. This section of bone will eventually fuse with the patient’s bone where it was originally cut.

What conditions or injuries do we treat with limb salvage surgery?

Our pediatric orthopedic oncology surgeons would consider this surgery for these medical issues or conditions:

• Osteosarcoma
• Ewing’s sarcoma
• Other childhood bone tumors
• Severe bone loss or complications after trauma

Is limb salvage surgery an alternative to amputation?

Amputation, rotationplasty and limb salvage surgery are treatment options for kids with bone sarcoma and deciding which is best for your child is a personal decision you should make with your care team. These surgeries have similar survival rates and quality of life outcomes, but a lot depends on your child’s specific condition and what’s important to them.

Limb salvage surgery can offer a more natural looking limb, walking motion and functionality, and doesn’t typically require a visible prosthetic. Often, this surgery has a longer rehabilitation, higher odds for additional surgeries and more follow-up care than amputation and rotationplasty.

How do I help prepare my child for limb salvage surgery?

In several meetings before surgery, your care team will explain the surgical process and when to stop eating and drinking before surgery. It’s also important for your child to meet other kids who had limb salvage surgery or other limb surgeries such as a rotationplasty. Our specialists can help arrange a meeting so your child can ask questions and see other kids who are thriving post-surgery. 

What to expect during limb salvage surgery

We perform this procedure under general anesthesia, which helps your child fall asleep and not feel pain. Limb salvage surgery is complex and has many steps, so how long it lasts can vary based on factors such as tumor location and size. Our surgeons begin by removing the cancerous tumor and, depending on the treatment option best for your child, add either bone or metal reconstruction to the limb. After we remove the tumor and add the new bone or metal, the surgeon will close the incision.

What to expect after limb salvage surgery

After surgery, your child may be in some pain, but we’ll help them manage it in collaboration with our pediatric anesthesia specialist who provides nerve blocks and other pain medication. Your child will stay in the hospital to recover an average of three to five days. Each surgery and child are different, which means healing time will also be different. After going home, your child may return to daily activities, follow-up treatment or rehabilitation once your child’s care team will help navigate recovery and therapy along the way.

What is the success rate of limb salvage surgery?

Limb salvage surgery success depends on multiple factors including the location of the tumor, size of the tumor and the type of limb salvage surgery your child has. Limb salvage surgery is also only an option for certain children.

Children who are suited for limb salvage surgery can have good long-term survival rates and quality of life that is comparable to kids who have limbs amputated for similar conditions or injuries. 

Why choose us for limb salvage surgery

Children’s Colorado is where medical experience, compassion, expertise and advanced technology meet. As the most experienced pediatric children’s surgery program in the region, we provide a team of experts who focus only on caring for kids. From pediatric orthopedics to plastic surgery, and many nurses, coordinators and physicians in between, we prepare an individualized treatment plan to treat any injury.

We use the latest surgical technology to ensure your child has the best possible experience. Our multidisciplinary care allows for collaboration with the University of Colorado School of Medicine Limb Restoration Program, our Limb Differences Program and the Department of Pediatric Plastic Surgery to develop custom reconstruction strategies to meet the needs of your child. Whether that is a custom implant or a 3D printed guide, our team is here to provide the highest standard of surgical care.

If you have any questions or concerns after the procedure, call the ParentSmart Healthline at 1-855-KID-INFO (543-4636). Caring pediatric nurses are available 24 hours a day, 7 days a week to help answer your questions.