Abstract
Aims: Reconstruction of bone continuity after wide resections for malignant tumours has always been a big problem in orthopaedic surgery. During the growing age the problem of reconstruction is harder because of the arrest of growing referring to the scheletal segment involved.
Authors present their experience with different surgical methods.
The choice of surgery depends on the age of the growing child and on the site of the neoplasm.
Methods: The personal series of the authors refer to nine osteogenic sarcomas (five of the distal femur, and four of the proximal tibia) and four Ewing’s sarcomas of the femoral diaphysis. The age of the patients was between nine and sixteen years.
Females were eight and males were five. After ten years only ten patients were disease free (seven osteogenic sarcomas and three Ewing’s sarcomas).
Results and conclusion: In four cases of osteogenic sarcoma the patients were under ten years of age and the surgical choice of Authors was dependent to the exention of the surgical resection including the growing cartilage and the normal growing of the controlateral scheletal segment. For this reason authors employed a conservative method using the association of the Ilizarov external fixator with a final arthrodesis employing a long intramedullary nail.
In five cases of o.s. the age of the patients was over fourteen years, the remaining growing period was limited and for this reason a mechanical growing prosthesis was employed.
In the four cases of diaphyseal Ewing’s sarcoma the reconstruction was performed in two cases employing an autologous graft taken from the iliac crest and in two cases a microvascularized fibular graft.
Functional results of the affected limb, in the surviving patients, depend on the sacrifice of the joint (arthro-dhesis) or in the use of a modular prosthesis that, in AA. experience have a follow-up of 12 years; in diaphyseal reconstruction an anatomical result was obtained either with the mcrovascularized fibular graft or with the autologous graft from the iliac crest, the only difference between these two methods depending on the time of bone healing.
The abstracts were prepared by incoming Professor Elena Brach del Prever. Correspondence should be addressed to IORS – President office, Dipartimento di Traumatologia, Ortopedia e Mediciana del Lavoro, Centro Traumatologico Ortopedico - Via Zuretti, 29 I-10135 Torino, Italy.
