Abstract
Aims: In patients who have malignant bone tumour (MBT) of the proximal extremities, it is often possible to carry out resection which salvage the limb. Reconstruction, however, remains a problem because none of the procedures which are available adequately compensates for the functional loss after amputation. Material and Methods:Between 1985 and 2001, 45 patients (p) with MBT or aggressive BT of the proximal extremities were reviewed. All (p) have pathologic confirmation. Among them 7 were osteosarcoma, 6 chondrosarcoma, 2 fibrosarcoma, 1 Ewing’s sarcoma, 1 plasmocitoma, 4 bone metastases and 24 giant cell tumour. Radiographs, CT, MRI, scan with Tc 99 m were useful for treatment decision. We used for reconstruction non vascularised fibular autografts in 29p, a free vascularised fubular grafts in 4 p.tibia grafts in 2 p. Ticoff-Limberg procedures in 1 p.resection of the proximal radius in 1 p.endoprosthesis of the proximal humerus in 4 p.and MMA cement and Rush-Pin in 4 p. The functional results were graded according to the rating system of the MSTS. The mean duration of follow-up was 64 months (12–201 m). Results:Our results were satisfactory with regard to pain, emotional acceptance and manual dextterity.29 p.were still alive at the time of the latest follow-up.2 p.died from other disease.14 p. died from the disease. Function and lifting ability were unsatisfactory in 4 p.(8,9%). Radiographs schow:2 p.(4,4%) with delayed union,4 p.(8,9%) had colaps or fracture of the head of the fibula,2 p. had local recurence. Conclusion: different methods of reconstruction of the proximal extremities after resection of the MBT are effective in selected cases.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
