Purpose: The purpose of this work was to analyse and compare survival in patients with osteosarcoma (OS) or Ewing sarcoma (EW) of the pelvis as a function of treatment.

Material and methods: This retrospective series included 31 patients with OS (n=15) or EW (n=16) of the pelvis who were given a homogeneous therapeutic sequence associating chemotherapy, surgery and/or radiotherapy. Mean follow-up was 37 months (2–144). Mean age was 20 years for EW and 28 years for OS. Localisations in the pelvis were: zone I (n=12), zone I and II (n=4), zone II (n=1), zone II and III (n=7), zone III (n=1), and zone I, II and III (n=6). All patients were given chemotherapy, 15 underwent surgery, and 16 were given radiotherapy alone. Five patients were given complementary radiotherapy after surgery. Actuarial survival curves were compared with the logrank test. Comparison factors were presence of surgical resection, presence of initial or secondary metastasis, tumour response (radiographic measure), and pathology (good or poor responder) after chemotherapy.

Results: Five-year survival rate for patients with EW was 53%, 31% for OS. There was no significant difference in survival rates between tumour type. The only factor significantly correlated with lower survival rate was presence of initial metastasis.

Discussion and conclusion : The pelvic localisation of osteosarcoma and Ewing sarcoma is a factor of poor prognosis. Unlike data reported in the literature, surgery did not appear to influence outcome, not being found to be a factor of better prognosis. Surgery does however appear to improve short-term survival. In the pelvic localisation, osteosarcoma appears to have a poorer prognosis in terms of survival than Ewing tumour.

Purpose: Tillaux fractures correspond to type III joint fractures involving the anterolateral tubercle of the inferior tibia in the Salter and Harris classification. These fractures generally occur by external rotation in children about 13 years old at the time the medial part of inferior growth cartilage of the tibial epiphysis has fused. The purpose of the present study was to analyse long-term outcome in a retrospective series of twenty children.

Material and methods: All twenty patients underwent physical examination and a standard radiographic work-up at last follow-up. Results were classed into three categories: good (free of pain, stiffness, gait impairment, joint degeneration), faire (moderate pain and/or stiffness and/or gait impairment without joint degeneration), poor (severe pain and/or severe stiffness and/or limping and/or joint degeneration).

Results: This series included eight boys and twelve girls, mean age 12.8 years (range 3.4 – 14.9). Mean follow-up was three years eleven months (range 12 months – 8 years 9 months). Eleven patients underwent surgical treatment and nine orthopaedic treatment. The lateral segment of the growth cartilage was open in all cases but the medial segment was open in two and completely closed in six. A computed tomography scan was required in one patient to assess displacement. Outcome was considered good in eighteen patients and fair in two. These two patients had persistent pain without functional impairment at about one year follow-up.

Discussion: Overall, the long-term outcome is good for Tillaux fractures if they are correctly identified and evaluated, with computed tomography if necessary, to enable appropriate surgical or orthopaedic treatment. Inappropriate management of this joint fracture can lead to joint incongruency and secondary degeneration. Most of these fractures occur in adolescents and secondary growth impairment is negligible. This type of fracture may also occur in adults. Prognosis is excellent with adapted treatment.