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Learn the Forequarter amputation for chondrosarcoma surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Forequarter amputation for chondrosarcoma surgical procedure.

Forequarter amputation removes the upper limb, scapula and lateral shoulder girdle en-bloc to achieve eradication of malignant tumours when limb-salvage is not possible.

Chondrosarcoma (CS) is the second most common primary bone tumour and the most common in adults. These range from low to high grade malignant cartilage tumours which may metastasise to the lungs. They are relatively insensitive to chemo- or radiotherapy meaning that surgery is the principal intervention. Five year survival ranges from 99% for low grade to 24% for dedifferentiated chondrosarcomas. Achieving adequate surgical margins to ensure the tumour is excised-bloc is the guiding oncological principle to avoid local recurrence; local recurrence is associated with metastasis and death. Therefore, in patients in whom limb-salvage is impossible due to tumour encroachment on nerves, blood vessels and joints, amputation may regrettably be the optimal oncological treatment for their chondrosarcoma.

Patients should undergo detailed pre-operative staging and counselling prior to surgery, including pre-operative assessment at a limb-fitting centre to aid post-operative rehabilitation.

Author: Jonathan Stevenson FRCS (Tr & Orth).

Institution: Royal Orthopaedic Hospital, Birmingham,UK.

Clinicians should seek clarification on whether any implant demonstrated is licensed for use in their own country.

In the USA contact: fda.gov
In the UK contact: gov.uk
In the EU contact: ema.europa.eu