Limb salvage surgery for bone tumors is contraindicated in which of the following scenarios?

• A Major neurovascular involvement by tumor with no reconstructable vessel ✓
• B Pathological fracture through the tumor after neoadjuvant chemotherapy
• C Chest metastasis at presentation in osteosarcoma
• D Tumor crossing the growth plate in a skeletally immature patient

Explanation

Absolute contraindications to limb salvage include major neurovascular involvement that renders the limb non-functional even after reconstruction, inability to achieve wide surgical margins, and pathological fracture causing tumour seeding throughout the limb compartment (though this is now considered relative with good chemotherapy response). Pulmonary metastasis (C) and growth plate crossing (D) are relative contraindications managed with modifications to the surgical plan. Vascular reconstruction with synthetic grafts can sometimes allow salvage if nerves are spared.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.