The ppt described the challenges and approach to limb salvage in resource poor setting especially in Africa.

1. LIMB SALVAGE IN A
DEVELOPING ECONOMY:
FUTILE OR AUSPICIOUS
Seyi Idowu
FWACS FMCS Ortho

2. Limb salvage, limb sparing or limb
saving techniques
 Procedures performed as alternatives to
amputations.
 Arthrodesis
 Arthroplasty
 Alloprosthetic composite
 Endoprosthetic reconstruction
 Rotationplasty

3. Limb salvage defined!

4. Indications
 Tumours : Bone and soft tissue sarcoma,
aggressive benign tumours
 Trauma: Mangled extremity, crush injuries
 Infections: Osteomyelitis, septic arthritis
(Native and non native joints)

5. Stages of limb salvage
 Resection or debridement
 Reconstruction with implant,EPR,SPACER,
External device, Autograft/ Allograft
 Soft tissue reconstruction

6. Before limb salvage!
 Consider type of lesion
 Consider stage and location
 BO-NE-VE-ST principle
 Cierny and Mader criteria
 Educate patient
 Physio and OT
 Gather human resources- MDT eg LAMON
 Aftercare

7. tumour
 Grimer etal 1997
 Cost of amputation $9442 + $16033 yrs
 Cost of EPR $21002 +1419yrs

8. trauma

9. Infection

10. Futile?

11. Audacious: recklessly bold

20. Auspicious : Conducive to success
 Effective and cheaper chemotherapy : NGO
 Precision imaging technique : MRI, CT, angiograms
 Human resources
 Multidisciplinary care: Lagos musculoskeletal oncology
network (LAMON)