ILIOSACRAL AND ILIOLUMBAR FIXATION AFTER INTERNAL HEMIPELVECTOMY FOR CHONDROSARCOMA OF THE ILIUM - DUAL TECHNIQUE OF STABILISATION

Chondrosarcoma involving the pelvic bones are rare tumors and their association with the pelvic viscera and neurovascular structures poses a challenging surgical problem in the era of limb salvage surgery. Presenting a 30 year old male with the diagnosis of chondrosarcoma of ilium extending to right sacroiliac joint and the adjacent sacrum treated with type-4 internal hemipelvectomy. Reconstruction was done fixing the transverse process of L4,L5 lumbar vertebra with remnant ilium using an L shaped rod and fixed with pedicled screws . Harvested left fibular strut was used to stabilize the remnant ilium with hemisacrum. Patient was mobilized with partial weight bearing in 8 weeks to full mobilization. Better understanding of the nature of the tumor and complex biomechanics of lumbosacral pelvic region is essential to attempt various novel stabilization techniques to transfer the spinal load to the legs leading to a better quality of life.