Complex Limb Salvage Surgery Saves Woman's Hand from Amputation After a Decade-Long Battle with Bone Tumour

For nearly a decade, a 42-year-old Anousha Pultee from Mauritius lived through repeated surgeries, uncertainty, and the fear of losing her right hand forever. When she arrived at Manipal Hospital Old Airport Road, the severity of her condition was immediately visible. Her right arm was wrapped carefully in a cloth sling, supported constantly by her left hand. Beneath the covering was an enormous swelling comparable to the size of a rugby ball extending from the base of her fingers all the way to her elbow.

Further evaluation revealed that Anousha had been battling a recurrent Giant Cell Tumour (GCT) of the bone for nearly 10 years. Though classified as a benign tumour, GCT is known to behave aggressively. It rapidly destroys bone and surrounding soft tissue and has a high tendency to recur if not completely removed. 

Over the years, Anousha had already undergone four major surgeries. Despite these interventions, the tumour had returned repeatedly, leaving her hand severely deformed and almost non-functional. Diagnosed in 2015, she initially underwent a wide excision of the tumour with fibular bone grafting. However, despite treatment, the tumour recurred, requiring another excision with wrist fusion in 2021, followed by a revision surgery with additional bone grafting in 2022. When the tumour returned yet again in late 2025, her condition had deteriorated significantly.

By the time she sought treatment, the tumour had drastically altered both the appearance and functionality of her hand. Her fingers had developed a claw-like deformity with reduced sensation, tingling, numbness and almost absent thumb movement. Simple daily activities had become nearly impossible. Due to the extent of the tumour and multiple recurrences, amputation had already been suggested elsewhere as the most likely option. However, for Anousha, losing her dominant hand meant much more than a surgical procedure. It meant losing independence.

Following detailed imaging, biopsies, and metastatic evaluation confirming that the tumour remained localised and non-cancerous, a multidisciplinary team decided to attempt an extremely complex limb salvage surgery instead of amputation.

Orthopaedic oncologists worked alongside plastic and reconstructive surgeons to create a personalised surgical plan aimed at removing the tumour while preserving the arm. The goal was not only to save the limb, but also to restore as much function, stability, and confidence as possible.

The surgery performed by a multidisciplinary team led by Dr. Srimanth BS, Lead Consultant - Orthopaedic Onco Surgery at Manipal Hospital Old Airport Road, lasted nearly 10 hours and involved multiple highly specialised procedures. Alongside him, Dr. Prashant Puranik, Lead Consultant - Reconstructive Oncology & Microsurgery, Department of Plastic Reconstructive & Cosmetic Surgery, Manipal Hospital Old Airport Road performed Anastomosis, a crucial step in flap procedures.

“First, the massive tumour was carefully removed. Since the tumour had extensively damaged the bone, the team harvested a large segment of bone from the patient’s right leg,” said Dr. Srimanth. “Using advanced microvascular surgical techniques, the blood supply of the transplanted bone was meticulously connected to the blood vessels in the forearm to ensure proper healing and long-term viability. A specialised fixation plate was then used to stabilise and reconnect the remaining portions of the arm between the elbow and fingers.”

Anousha recovered without any major intraoperative or postoperative complications, and postoperative imaging confirmed satisfactory reconstruction. During recovery, her reconstructed hand maintained healthy blood circulation, she gradually regained finger movements and sensation including touch and temperature. One month later, Anousha’s recovery has shown promising progress. Most importantly, she has been able to keep her hand, something that once seemed nearly impossible.

“The happiness on her face during rehabilitation reminded us why limb salvage matters. This was not just about saving a hand. It was about restoring dignity, confidence, and a sense of normalcy,” Dr. Srimanth shared, highlighting how the case reflects what modern limb salvage surgery can achieve when expertise, teamwork, and advanced reconstruction techniques come together.