J Korean Orthop Assoc.  2008 Aug;43(4):433-437. 10.4055/jkoa.2008.43.4.433.

The Clinical Results of En Bloc Proximal Fibula Resection for the Treatment of Fibular Head Tumor

• Jung ST
• Park KS
• Chung JY
• Kim HJ
• Park GH

• KMID: 1480402
• DOI: http://doi.org/10.4055/jkoa.2008.43.4.433

Abstract

PURPOSE: We retrospectively reviewed cases of en bloc resection of the proximal fibula for the treatment of tumor arising from the fibular head.
MATERIALS AND METHODS
Between April 1996 and August 2006, 10 patients who underwent en bloc proximal fibular resection and were followed for at least 12 months were included in this study. The mean age was 27.1 years (range, 5-60 years) and the mean follow-up duration was 64.7 months (range, 12.7-140.6 months). The type of en bloc resection was classified according to the Malaweros resection criteria and the postoperative clinical results were evaluated according to the range of motion, knee joint stability and Musculoskeletal Tumor Society (MSTS) functional scoring system.
RESULTS
All patients were able to move the knee joint from 0degrees extension to 145degrees flexion except one patient with flexion contracture of 5degrees. Grade 1 lateral instability of the knee joint was present in two patients. The average MSTS function score was 92.6% (range, 73-100%). There was one patient with lung metastasis who was underwent lobectomy, but there were no patients with local recurrence.
CONCLUSION
En bloc resection of the proximal fibula for the treatment of tumors arising from the fibular head is a useful therapeutic method that preserves the knee stability and promotes good functional outcome.

Keyword

Fibular; Bone tumor; En bloc resection

MeSH Terms

Contracture
Fibula
Follow-Up Studies
Head
Humans
Knee
Knee Joint
Lung
Neoplasm Metastasis
Range of Motion, Articular
Retrospective Studies

Figure

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  Fig. 1 (A) Radiographs and MRI in a 42-year-old woman show a left fibular mass lesion with soft tissue extension (giant cell tumor). (B) Radiographs taken after type I resection of tumor show one staple fixed to the proximal tibia lateral wall with the lateral collateral ligament. (C) At 49 months after resection, the patient had no lateral instability of the knee joint, and her MSTS function score was 100%.

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  Fig. 2 (A) Radiographs and (B) MRI in a 17-year-old man show proximal fibula mass lesion and soft tissue extension (osteosarcoma). (C) Radiographs were taken after Type II resection of osteosarcoma. (D) Radiographs of the ankle 43 months after tendon transfer and tripe arthrodesis demonstrate fusion of triple joint. Although there was grade 1 knee joint lateral instability, the patient's MSTS function score was 90%.

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