🔍 Key Findings

• Limb-sparing surgery aims to preserve limb function after resection of diseased bone, most commonly for appendicular osteosarcoma but also for non-repairable fractures causing critical bone defects.
• Survival outcomes after limb-sparing can be comparable to limb amputation, providing an alternative for owners who decline amputation or for dogs poor candidates for amputation.
• Techniques fall into two main categories: reconstruction of the bone defect or procedures that avoid reconstruction, depending on tumor location and surgical strategy.
• Common reconstructive techniques include cortical allografts, endoprostheses, bone transport osteogenesis, vascular or non-vascular autografts, and tumor-treated autografts.
• Non-reconstruction procedures include partial scapulectomy, partial ulnectomy, or limb shortening, which preserve limb function without rebuilding the bone defect.
• Major contraindications include detectable metastatic disease and extensive soft tissue involvement, although criteria such as pathologic fracture remain controversial.
• Complications are common and include infection, biomechanical failure, and local tumor recurrence, often due to extensive surgery, implants, chemotherapy-associated immunosuppression, and limited soft tissue coverage.
• Technique selection depends on anatomical site, available equipment, surgeon expertise, and owner factors, and comparative outcome data for many techniques remain limited.