Hemipelvectomy
Encyclopedia
A hemipelvectomy is a high level pelvic amputation
Amputation
Amputation is the removal of a body extremity by trauma, prolonged constriction, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for...

. Along with hip disarticulations, hemipelvectomies are the rarest of lower extremity amputations. In some cases, an internal hemipelvectomy can be performed, which is a limb-sparing procedure. A complete hemipelvectomy, however, is the amputation of half of the pelvis
Pelvis
In human anatomy, the pelvis is the lower part of the trunk, between the abdomen and the lower limbs .The pelvis includes several structures:...

 and the leg
Leg
Łęg may refer to the following places in Poland:*A former name for the town of Ełk *Part of the Czyżyny district of Kraków*Łęg, Pleszew County in Greater Poland Voivodeship...

 on that side. This type of procedure is also called transpelvic amputation.

Hemipelvectomies may be required for several reasons, such as a car accident or cancer. Examples of cancers that can require hemipelvectomies are sarcoma
Sarcoma
A sarcoma is a cancer that arises from transformed cells in one of a number of tissues that develop from embryonic mesoderm. Thus, sarcomas include tumors of bone, cartilage, fat, muscle, vascular, and hematopoietic tissues...

s like Ewing's Sarcoma, osteosarcoma
Osteosarcoma
Osteosarcoma is an aggressive cancerous neoplasm arising from primitive transformed cells of mesenchymal origin that exhibit osteoblastic differentiation and produce malignant osteoid...

 or chondrosarcoma
Chondrosarcoma
Chondrosarcoma is a cancer composed of cells derived from transformed cells that produce cartilage. Chondrosarcoma is a member of a category of "soft tissue" malignancies known as sarcomas. About 30% of skeletal system cancers are chondrosarcomas...

.

People who have experienced a hemipelvectomy may or may not be able to use a prosthesis
Prosthesis
In medicine, a prosthesis, prosthetic, or prosthetic limb is an artificial device extension that replaces a missing body part. It is part of the field of biomechatronics, the science of using mechanical devices with human muscle, skeleton, and nervous systems to assist or enhance motor control...

. They may use adaptive devices such as a wheelchair
Wheelchair
A wheelchair is a chair with wheels, designed to be a replacement for walking. The device comes in variations where it is propelled by motors or by the seated occupant turning the rear wheels by hand. Often there are handles behind the seat for someone else to do the pushing...

, underarm crutches, forearm crutches, or, in the case of internal hemipelvectomies, a cane.

Physical therapy
Physical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...

 can be useful to those with hemipelvectomies to build strength and prevent problems like back pain and scoliosis
Scoliosis
Scoliosis is a medical condition in which a person's spine is curved from side to side. Although it is a complex three-dimensional deformity, on an X-ray, viewed from the rear, the spine of an individual with scoliosis may look more like an "S" or a "C" than a straight line...

. Because a hemipelvectomy is a rare type of amputation, it is important that the physical therapist is trained in the special needs of a post-hemipelvectomy patient.

There are two types of hemipelvectomy:
  • External - Amputation of the whole leg plus the pelvis on that side. The other name for external hemipelvectomy is called a hindquarter amputation.
  • Internal - Removal of the pelvis on the one side, but the leg is saved.

External links

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