Introduction: For extensive osseous involvement of primary tumours in the distal femur and proximal tibia, knee resection arthrodesis (KRA) is an economic alternative to endoprosthetic reconstruction in developing countries. Enneking (1977) described the use of an intramedullary (IM) nail for KRA and is still regarded as the most reliable method for fusion. We sought to determine if dual plating or IM nailing for KRA would produce comparable outcomes. Materials and methods: This is a cross-sectional study of 30 patients who underwent KRA with either IM nail or dual plates for tumours about the knee. Demographic and surgical profile, functional scores using the Musculoskeletal Tumour Society (MSTS) score, and incidence of complications were determined. Results: Mean follow-up was 2.28 years (SD 20.4). IM nail was utilised in 12 (40%) and dual plating in 18 (60%). 21 complications occurred, with 11 (52.38%) and 10 (47.62%) occurring in the IM nail and dual plating group respectively. MSTS score was higher with the IM nail (23.5 vs 22.5). Mean operative time was longer with the IM nail compared to dual plating (8.29 vs 7.80 hours). Blood loss was higher with the IM nail (1309.09 vs 1138.89mL). Conclusion: Outcomes of IM nailing and dual plating KRA are comparable, including the incidence of complications. While blood loss and operative time were noted to be longer in the IM nailing group, and hospital admission was longer in the dual plating group, the difference was not significant. Larger, prospective studies are recommended to report outcomes for fusion done following tumour resection.

A chronic expanding hematoma (CEH) is a rare clinicopathologic entity that may simulate the clinical and radiologic presentation of soft tissue sarcomas. Etiology has been attributed to repeated exudation and bleeding from capillaries in granulation tissue, resulting in a gradually enlarging mass. A 51-year-old male presented with a large thigh mass following a gunshot wound one year prior. Diagnostic imaging revealed a large complex mass with cystic areas overlying cortical erosions in the femoral diaphysis suggestive of osteomyelitis versus a primary aggressive new growth. Biopsy confirmed CEH and the absence of malignant cells. Hip disarticulation was performed after noting massive necrosis of the thigh compartments and neurovascular compromise. CEH is an important differential diagnosis to be considered in a patient with a slow-growing soft tissue mass and history of significant trauma. Its similar clinical presentation with a soft tissue sarcoma necessitates a high index of suspicion, diagnostic imaging, and biopsy prior to performing definitive surgery.