The aims of this study were to analyse the long-term outcome
of vascularised fibular graft (VFG) reconstruction after tumour
resection and to evaluate the usefulness of the method. We retrospectively reviewed 49 patients who had undergone resection
of a sarcoma and reconstruction using a VFG between 1988 and 2015.
Their mean follow-up was 98 months (5 to 317). Reconstruction was
with an osteochondral graft (n = 13), intercalary graft (n = 12),
inlay graft (n = 4), or resection arthrodesis (n = 20). We analysed
the oncological and functional outcome, and the rate of bony union
and complications.Aims
Patients and Methods
We hypothesised that the use of computer navigation-assisted
surgery for pelvic and sacral tumours would reduce the risk of an
intralesional margin. We reviewed 31 patients (18 men and 13 women)
with a mean age of 52.9 years (13.5 to 77.2) in whom computer navigation-assisted
surgery had been carried out for a bone tumour of the pelvis or
sacrum. There were 23 primary malignant bone tumours, four metastatic
tumours and four locally advanced primary tumours of the rectum.
The registration error when using computer navigation was <
1 mm
in each case. There were no complications related to the navigation,
which allowed the preservation of sacral nerve roots (n = 13), resection
of otherwise inoperable disease (n = 4) and the avoidance of hindquarter
amputation (n = 3). The intralesional resection rate for primary
tumours of the pelvis and sacrum was 8.7% (n = 2): clear bone resection
margins were achieved in all cases. At a mean follow-up of 13.1
months (3 to 34) three patients (13%) had developed a local recurrence.
The mean time alive from diagnosis was 16.8 months (4 to 48). Computer navigation-assisted surgery is safe and has reduced
our intralesional resection rate for primary tumours of the pelvis
and sacrum. We recommend this technique as being worthy of further
consideration for this group of patients. Cite this article:
