A hemipelvectomy is a surgical procedure in which one leg and a portion of the pelvis are removed. The range of a hemipelvectomy can vary, with some procedures involving a removal of half of the pelvis, while others require removal of less than half. This surgery can be very traumatic for the patient, and is used as a treatment of last resort; when a surgeon recommends a hemipelvectomy, in other words, he or she thinks that it is necessary for the patient.
This is one of the rarest amputations. Patients typically receive a hemipelvectomy because of a cancer which cannot be treated in any other way, or because of a traumatic accident such as a crush injury on a factory floor or a severe car accident. In a traumatic hemipelvectomy, the patient's pelvis and leg may have been so severely damaged that a surgeon feels they cannot be reconnected, and that it would be better for the patient to amputate and avoid the risk of infection.
In some cases, a surgeon may be able to perform an internal hemipelvectomy, also known as a “limb salvage” procedure. In this case, part of the pelvis is removed, but the limb is left intact, and the surgeon may implant an artificial joint or prosthesis. The level of functionality for the patient after this procedure can vary, with some patients experiencing total loss of use of the limb, while others may be able to retain some function. Surgeons also need to monitor the site in case the need for a full amputation emerges.
In a bilateral hemipelvectomy, both limbs are removed. Another procedure, known as a hip disarticulation, involves total removal of the leg at the hip joint, with the pelvis left intact. In some cases, part of the hip joint may be left in place for stabilization or comfort. This procedure is also very traumatic for the patient and can require an extensive recovery time.
After a hemipelvectomy, a patient is usually encouraged to attend physical therapy. Patients can learn to walk with crutches or prosthetics, and may enjoy a high level of freedom of movement, rather than being confined to a wheelchair or to bed. Recovery rates vary, depending on the patient, the need for the amputation, and the amputation procedure itself. Patients who have undergone hemipelvectomies can sometimes benefit from joining a support group which provides information about everything from tips and tricks for patients living without a leg to a friendly person to talk to.