Der Orthopäde
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The purpose of this study was to compare quality of life and subjective well-being between patients who underwent either amputation or limb-salvage procedures for lower extremity sarcomas in order to determine if this aspect can be considered in the decision on the type of surgery. Sixty-six patients were evaluated at least 1 year after surgery and systemic therapy for lower extremity sarcomas. Self-report questionnaires such as the Quality of Life Questionnaire (QLQ-C30), the Life Satisfaction Questionnaire (FLZ), and the Enneking Score (MSTS) were used. ⋯ Additionally, a correlation between subjective well-being and the location of either amputation or reconstruction ( p=0.039, r(p)=- 0.309) could be shown. These findings demonstrate that the type of surgery has no influence on quality of life and subjective well-being after lower extremity sarcomas. Thus the decision for either limb-salvage procedures or amputation cannot be based on quality of life and subjective well-being but must be determined by oncological criteria.
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This paper presents guidelines for indications, risks, and technical aspects of removal of metal works. The indications comprise the general condition of patient, age, location of the implant, risks and disadvantages of the procedure. Problems concerning removal of metal are for example: lesions to nerves and re-fracture. ⋯ The issue of obtaining the consent of a patient to an operation, often not an operation for novice, may not be neglected. Lesions to nerves are amongst the most common complications. The technical guidelines refer to the specific locations and to the problem of broken intramedullary nails.