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Oncologic Approaches to Pediatric Limb Preservation

Dr. Weisstein is Partner, Tucson Orthopaedic Institute, Center for Orthopaedic Oncology, Tucson, AZ. Dr. Goldsby is Assistant Professor of Clinical Pediatrics, Department of Pediatrics, University of California, San Francisco, CA. Dr. O’Donnell is Associate Professor of Clinical Orthopaedic Surgery, University of California, San Francisco.

Dr. Weisstein or the department with which he is affiliated has received research or institutional support from a commercial source or sources. Neither Dr. Goldsby nor the department with which he is affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article. Dr. O’Donnell or the department with which he is affiliated has received research or institutional support from a commercial source or sources.

Reprint requests: Dr. O’Donnell, UCSF Comprehensive Cancer Center, University of California at San Francisco, 1600 Divisadero Street, San Francisco, CA 94115-1939.

Preservation of limb function in the pediatric oncology patient is uniquely challenging. Treatment must be strictly prioritized in terms of the patient’s life, the limb, its function, length equalization, and cosmetic appearance. At the same time, social, socioeconomic, and cultural factors must be understood and respected to achieve the most advantageous outcome for both the patient and family. Given these considerations, as well as the relative rarity of many oncologic diagnoses and the myriad of presentation scenarios, drafting generalized treatment recommendations is difficult. Instead, orthopaedic intervention in the care of children and young adults with oncologic conditions must be individualized, with the broad goal being optimization of limb function rather than rigid advocacy of limb salvage.

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