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Sarcoma - Pediatric Limb Preservation

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Moffitt Cancer Center and All Children's Hospital are among the leaders in North America in pediatric limb preservation. The use of expandable prostheses for limb salvage in children and adolescents was first described in the early 1990s. Initially, custom-made devices required major surgeries to obtain the desired expansion, and in some instances, multiple procedures throughout the year were required. As technology advanced, the lengthening of the device became easier and less invasive. The lengthening could then be done in an outpatient surgical setting with minimally invasive surgery, less complications and faster recovery.

A novel technique has been developed where the lengthening procedures can be performed in an outpatient clinic setting. No surgery and no anesthesia are required for the lengthening, and the procedure requires 15 to 20 minutes. This prosthesis was developed by Stanmore in the United Kingdom. It works by a complex mechanism where a magnet activates the lengthening gears (in a similar way as the minimally invasive procedure using a conventional screw driver). For every 2,000 revolutions of the magnet, the prosthesis lengthens 1 millimeter. With this new technology, the limb can easily be lengthened in short intervals to lessen the complications, and does not need aggressive rehabilitation after each procedure. There are no surgical incisions to heal, and patients do not have any discomfort from the lengthening.

Moffitt Cancer Center has performed more than 40 of these limb preservation procedures in children, and about 25% of them have used the new non-invasive Stanmore magnetic device.

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