Internal hemipelvectomy

Until recently, tumours involving the pelvis were usually treated by hemipelvectomy, otherwise called ‘hindquarter amputation’. A more recent approach of treating these tumours is the ‘conservative hemipelvectomy’, which consists of removing the tumour and sparing the lower extremity. A patient with Ewingʹs sarcoma of the pelvis underwent such a procedure. The femoral head was fixed temporarily to the remaining parts of the acetabulum and the iliac wing by a Steinman pin. The Steinman pin was removed 6 weeks after the operation and the patient was then put into traction for another 6 weeks. Weight-bearing was gradually allowed after 3 to 6 months. The patient remodelled a neoacetabulum, which gave sufficient stability to the hip joint. Walking without external help was possible. The patient presented with a 2 cm limb-shortening. No local recurrence was observed during a follow-up of 30 months. This experience with internal hemipelvectomy shows an encouraging result in terms of tumour control and gait function.