Due to advances in adjuvant therapy, the outlook for patients with pri
mary malignant bone tumors has dramatically improved over the last dec
ades. This is true for improved survival and also for increased limb s
alvage rates. Technical aspects of the standard limb salvage procedure
s such as Tikhoff Linberg resection in the shoulder region, internal h
emipelvectomy, proximal and distal femur resection and rotationplasty
are demonstrated. The use of soft tissue procedures like flaps and the
use of modular implant systems has reduced complication rates. In the
future, we hope to further improve the outlook for our patients with
risk adapted chemotherapeutic regimes and surgical procedures.