Patients with infected, painful, or necrotic lower extremities can be restored to a better functional level by means of a properly selected and performed amputation. This procedure should be considered reconstructive and restorative. In what follows, I address amputations across the toe, the forefoot, the leg, and the thigh.

This patient has a very interesting clinical history. On this occasion, presenting with a pathological fracture secondary to a Pleomorphic rhabdomyosarcoma with a high mitotic rate. This was an extremely aggressive and highly malignant tumour and is the fourth primary tumour for this patient. The surgery was performed at St. Vincent’s private hospital in Sydney. The removal of the tumour, which had infiltrated the soft tissue surrounding the femoral shaft, took many hours. The length of bone removed measured 24 centimeters or 9.5 inches. As can be seen in the gallery below, the ‘osteobridge’ modular diaphyseal prosthesis was used to bridge the gap and restore length. The patient was ambulating on day two post-op. (illustrated)

JBJS B 78; 4; 1022 1996 full text
Custom made endoprostheses were used in 18 patients with median follow-up 65 months. "We conclude that diaphyseal endoprostheses offer a good clinical and functional outcome in the lower limb"

Abstract:Uncemented short-length diaphyseal segmental replacement prosthesis fixation - Finite element analysis and long-term results
Journal of Orthopaedic Research Volume 23, Issue 5 , Pages 1065 - 1072 Published Online: 1 Jan 2006
Conclusions: A short-length fixation system based on intramedullary anchorage of segmental replacement endoprostheses would possibly support physiologic adaptive processes more than fixation over the full length of the stem.