Type 1 pelvic resection
Type 1 pelvic resections are complex surgeries that involve removing part of the pelvis, usually to resect malignant tumour.
Type 1 pelvic resections remove a varying amount of the iliac bone, and are classified in general terms as "partial" or "complete", depending on how much of the iliac bone is resected. The acetabulum is spared (and this is one of the largest benefits of this procedure over a hemipelvectomy).
The iliac bone provides:
- weight support from the body to the ipsilateral lower limb
- an attachment site for muscles, ligaments, and tendons
Resection of the iliac bone therefore provides many technical challenges if the surgeon wants to preserve as much function as possible. Bony grafts (e.g. fibula) and arthoplasty/prosthesis hardware can be used to try to reproduce some of the iliac bone's functions. If the defect is small, the pelvic ring can also be "closed down" with a wired arthodesis between the residual iliac bone and the sacrum.
Some further divide type 1 resections into
- type 1-A: removal of the gluteal muscle
- type 1-S: removal of part of the sacrum (also called "type 4" by some)
- 1. Enneking WF, Dunham WK. Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am. 1978;60 (6): 731-46. Pubmed citation
- 2. Hugate R, Sim FH. Pelvic reconstruction techniques. Orthop. Clin. North Am. 2006;37 (1): 85-97. doi:10.1016/j.ocl.2005.08.006 - Pubmed citation