Hemipelvectomy

Abstract

The hemipelvectomy, most commonly performed for pelvic tumor resection, is one of the most technically demanding and invasive surgical procedures performed today. Adequate soft tissue coverage and wound complications after hemipelvectomy are important considerations. Rehabilitation after hemipelvectomy is optimally managed by a multidisciplinary integrated team. Understanding the functional outcomes for this population assists the rehabilitation team to counsel patients, plan goals, and determine discharge needs. The most important rehabilitation goal is the optimal restoration of the patient's functional independence. Factors such as age, sex, etiology, level of amputation, and general health play important roles in determining prosthetic use. The three main criteria for successful prosthetic rehabilitation of patients with high-level amputation are comfort, function, and cosmesis. Recent advances in hip and knee joints have contributed to increased function. Prosthetic use after hemipelvectomy improves balance and decreases the need for a gait aid. Using a prosthesis helps maintain muscle strength and tone, cardiovascular health, and functional mobility. With new advances in prosthetic components, patients are choosing to use their prostheses for primary mobility.

Survival rate and perioperative data of patients who have undergone hemipelvectomy: a retrospective case series

“…Persistent postsurgical pain (pain that lasts for more than 1–2 months after surgery) has been reported to be present in more than 30 % of patients after procedures, such as amputations, and its recognition is increasing [ 22 ]. Studies have shown that up to 90 % of patients may experience phantom pain after hemipelvectomy-associated amputation, and although the mechanisms of pain after this procedure are not fully understood, the pain can be debilitating and may impair rehabilitation and quality of life [ 22 , 23 ]. Neurotoxic chemotherapy, moderate-to-severe postoperative pain, anxiety, younger age (adults), radiation therapy in the operated area, and preoperative pain (moderate to severe) for more than 1 month were previously identified as risk factors for the development of chronic postsurgical pain [ 24 , 25 ], and all or at least some of these factors may be present in hemipelvectomy patients.…”

Half man, half prosthesis: the rehabilitation of people with hemicorporectomy – case series

“…However, with prosthetic advances, patients are increasingly opting for prosthesis for primary locomotion. 35 In our work, patients maintained the use of prostheses for outdoor activities, short-distance walking indoors and outdoors for short distances or social presentation.…”

Rehabilitation and functional outcomes for thoraco-omphalo-ischiopagus conjoined twins five years after separation: A case report

“…This was somewhat complicated by the presence of their ileostomy/colostomy which limited the surface area available for applying corrective forces to the curve. Additionally, adequate suspension for a hemipelvectomy prosthesis often requires a shoulder strap, but this was not needed for these twins given they already had a TLSO component that would provide more surface area for suspension [4]. Within six months following inpatient rehabilitation, the twins progressed to pulling to stand and began cruising without a prosthesis in parallel bars.…”