Hindquarter amputation (hemipelvectomy) is a major operation to remove the entire lower limb along with part of the pelvis. It is performed for large, locally advanced tumours of the pelvis or proximal thigh when limb salvage is not possible.
An extensive incision is made around the hip and pelvis. The pelvic bone is cut, and the entire lower limb with the hemipelvis is removed. Large myocutaneous flaps are fashioned to close the defect. The operation is one of the most extensive in orthopaedic oncology and takes four to six hours.
Hindquarter amputation is reserved for locally advanced pelvic or proximal thigh tumours that encase major neurovascular structures, making limb salvage unsafe. It is a rare but sometimes necessary operation.
Internal hemipelvectomy (limb salvage with pelvic resection), radiotherapy, and chemotherapy.
Specialist sarcoma centre. Full staging. MDT discussion. Comprehensive pre-operative assessment. Psychological preparation.
Complete local tumour removal when no other option is available. Relief of pain from a non-functional or tumour-burdened limb.
Very common and may be severe.
Loss of the entire lower limb and part of the pelvis.
Very large wound with significant risk of delayed healing.
Major blood loss requiring transfusion.
Particularly with prior radiotherapy.
Bowel, bladder, or sexual dysfunction.
Through the pelvic floor defect.
Severe impact on quality of life.
General anaesthesia. Major surgery with massive blood loss potential.
Prolonged hospital stay. Sitting rehabilitation (custom seating). Some patients achieve walking with specialised prosthetics but this is physically demanding. Wheelchair use is common. Intensive psychological support. Occupational therapy.
Oncology surveillance. Rehabilitation and prosthetic review. Long-term psychological support.
Some patients achieve walking with specialised prosthetics, but this requires significant effort and fitness. Many patients use a wheelchair for longer distances. Quality of life can still be good with appropriate support and adaptation.