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Comparative Study
. 2005 Aug;29(4):255-9.
doi: 10.1007/s00264-005-0656-4. Epub 2005 Jun 11.

Treatment of primary malignant bone tumours of the distal tibia

M Laitinen  1 , J Hardes, H Ahrens, C Gebert, B Leidinger, M Langer, W Winkelmann, G Gosheger
Affiliations
Comparative Study

Treatment of primary malignant bone tumours of the distal tibia

M Laitinen et al. Int Orthop. 2005 Aug.

Abstract
in English, French

We treated 15 patients with primary malignant bone tumours of the distal tibia of which 14 were treated by limb salvage surgery. Reconstructions were done by allografts with or without microvascular fibula transfer, by bone transport, by fibula transfer alone or by endoprosthetic replacement. The most successful methods were bone transport and endoprosthetic replacement. However, serious complications with deep infections leading to secondary amputation occurred in four patients and in all reconstruction groups. After a mean follow up of 7 years, no local recurrence occurred, and all patients were alive and free of disease. After radical resection, bone transport in defects less than 15 cm is a viable option. In larger defects in children, allograft with vascularised fibula is an acceptable alternative, but amputation still has a role in this group. In adults, endoprosthetic replacement with proper soft tissue coverage is a viable option in cases with large bony defects.

Nous avons traité 15 malades avec une tumeur maligne primitive du tibia distal avec pour 14 d’entre eux une chirurgie conservatrice du membre. Les reconstructions ont été faites par allogreffe avec ou sans transfert de péroné vascularisé, transport osseux, transfert du péroné seul ou par remplacement prothétique. Les meilleures méthodes étaient le transport osseux et le remplacement prothétique. Des complications sérieuses avec infection profonde menant à une amputation secondaire, se sont cependant produites chez quatre malades et dans tous les groupes de reconstruction. Après un suivi moyen de 7 ans, aucune récidive locale n’est survenue et tous les malades sont vivants et libres de maladie. Après une résection radicale, le transport osseux dans les défauts de moins de 15 centimètres est une option valable. Dans plus grands défauts chez les enfants, l’allogreffe avec péroné vascularisé est une alternative acceptable, mais l’amputation a encore un rôle dans ce groupe. Chez les adultes le remplacement prothétique avec couverture cutanée adéquate est un choix valable dans les grands défauts osseux.

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Figures

Fig. 1
Fig. 1
a Post-operative radiograph showing the resected area with a temporary cement spacer. b Ongoing bone transport with external fixation. c, d Final results after completed bone transport.
See this image and copyright information in PMC

References

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