Intercalary Resection and Reconstruction for Malignant Bone and Soft Tissue Tumor of Lower Extremity.
- Author:
Dae Geun JEON
1
;
Jong Seok LEE
;
Chang Kyu PARK
;
Soo Hee KIM
;
Yong Gul DONG
;
Soo Yong LEE
Author Information
1. Department of Orthopedic Surgery, Korea Cancer Center Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Low extremity;
Malignant tumor;
Intercalary resection;
Reconstruction
- MeSH:
Follow-Up Studies;
Hot Temperature;
Humans;
Lower Extremity*;
Prognosis;
Transplants
- From:The Journal of the Korean Orthopaedic Association
2001;36(4):327-331
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was undertaken to evaluate methods of reconstruction and their functional outcomes for segmental resections of the long bones of the lower extremity . MATERIALS AND METHODS: Eighteen cases were eligible for this study. There were 11 femoral lesions and there were 7 tibial. Lesions that had a good bone stock were reconstructed by means of a combination of rigid fixation and heat treated autogenous bone (Group1: in which there were 11 cases). Osteolytic lesions and those that necessitate a pathologic analysis underwent a temporary fixation procedure using intramedullary nail and bone cement (Group 2:7 cases). The average follow-up period was 49 (12-160) months. RESULTS: At the final follow-up examination, 15 patients were disease free, 2 had died of disease and remaining one was alive with disease. There were a total of 10 complications, 7 occurred in Group 1 and 3 in Group 2. Four cases of nonunion in Group 1 had a solid union after augumentation bone graft and a change of fixation device. Average union time for the recycled bone was 15 (9-35) months and their average functional score was 25.8. CONCLUSION: Although reconstruction by heat treated bone is a feasible, inexpensive method that has a low infection rate, the union process is not always successful. A rigid initial fixation is essential for a primary union. Temporal fixation using an IM nail and cement is a relatively sound method both functionally and technically and it might be useful in cases where the prognosis is unpredictable.
