[Surgical treatment of locally aggressive and malignant tumors of the proximal third of the fibula. Oncology results and functional evaluation].

Autor: Farfalli GL; Ortopedia y Traumatología, Sector de Ortopedia Oncológica y Trasplantes Óseos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Albergo JI; Ortopedia y Traumatología, Sector de Ortopedia Oncológica y Trasplantes Óseos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: Jose.albergo@hiba.org.ar., Ayerza MA; Ortopedia y Traumatología, Sector de Ortopedia Oncológica y Trasplantes Óseos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Muscolo DL; Ortopedia y Traumatología, Sector de Ortopedia Oncológica y Trasplantes Óseos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Aponte-Tinao LA; Ortopedia y Traumatología, Sector de Ortopedia Oncológica y Trasplantes Óseos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Jazyk: Spanish; Castilian
Zdroj: Revista espanola de cirugia ortopedica y traumatologia [Rev Esp Cir Ortop Traumatol] 2014 Jul-Aug; Vol. 58 (4), pp. 212-6. Date of Electronic Publication: 2014 Jan 22.
DOI: 10.1016/j.recot.2013.11.006
Abstrakt: Introduction: Proximal fibula malignant and locally aggressive benign bone tumors are uncommon and usually treat by surgery. Bloc resection of the knee can compromise knee stability due to of the resection of the posterolateral ligament complex.
Material and Methods: We analyzed 28 consecutive patients treated for a proximal fibula bone tumor between 1980 and 2006 (osteosarcoma: 9, giant cell tumor: 9, Ewing sarcoma: 8 and chondrosarcoma: 2). Sixty-one percent were male and the median age was 21 years (range: 8-60). The mean follow-up was 86 months. The posterolateral complex was reinserted at tibial metaphyseal level. Patients were evaluated functionally using the Musculoskeletal Tumor Society scale (MSTS).
Results: Overall survival rate was 89%, local recurrence rate was 11%, and secondary amputation rate was 6% at 7 years of median follow-up. The average MSTS score was 93%. Five patients had neurological complications. No patient experienced subjective instability or vascular insufficiency.
Conclusions: Bloc resection of the proximal fibula for the treatment of aggressive or malignant primary bone tumors allowed us to obtain local tumor control, and overall survival rate for sarcomas of 89% at 7 years. The posterolateral ligament complex tibial reinsertion provided functional knee stability without major functional consequences in the medium term.
(Copyright © 2013 SECOT. Published by Elsevier Espana. All rights reserved.)
Databáze: MEDLINE
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