Intercalary Resection and Reconstruction for Malignant Bone and Soft Tissue Tumor of Lower Extremity

Jeon, Dae Geun; Lee, Jong Seok; Park, Chang Kyu; Kim, Soo Hee; Dong, Yong Gul; Lee, Soo Yong

Abstract

PURPOSE
This study was undertaken to evaluate methods of reconstruction and their functional outcomes for segmental resections of the long bones of the lower extremity .
MATERIALS AND METHODS
Eighteen cases were eligible for this study. There were 11 femoral lesions and there were 7 tibial. Lesions that had a good bone stock were reconstructed by means of a combination of rigid fixation and heat treated autogenous bone (Group1: in which there were 11 cases). Osteolytic lesions and those that necessitate a pathologic analysis underwent a temporary fixation procedure using intramedullary nail and bone cement (Group 2:7 cases). The average follow-up period was 49 (12-160) months.
RESULTS
At the final follow-up examination, 15 patients were disease free, 2 had died of disease and remaining one was alive with disease. There were a total of 10 complications, 7 occurred in Group 1 and 3 in Group 2. Four cases of nonunion in Group 1 had a solid union after augumentation bone graft and a change of fixation device. Average union time for the recycled bone was 15 (9-35) months and their average functional score was 25.8.
CONCLUSION
Although reconstruction by heat treated bone is a feasible, inexpensive method that has a low infection rate, the union process is not always successful. A rigid initial fixation is essential for a primary union. Temporal fixation using an IM nail and cement is a relatively sound method both functionally and technically and it might be useful in cases where the prognosis is unpredictable.