Physeal-preserving endoprosthetic replacement with short segment fixation in children with bone sarcomas
| Autor: | Yusuke Tsuda, Scott Evans, Jonathan Stevenson, Deepak V. Sree, Adesegun Abudu, Tomohiro Fujiwara |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Adolescent Prosthesis Implantation Bone Neoplasms Bone Sarcoma Prosthesis Design law.invention Intramedullary rod law medicine Humans Orthopedics and Sports Medicine Humerus Femur Growth Plate Tibia Child Physis Osteosarcoma business.industry Prostheses and Implants Recovery of Function Plastic Surgery Procedures Limb Salvage medicine.disease Fracture Fixation Intramedullary Prosthesis Failure Surgery medicine.anatomical_structure Female business |
| Zdroj: | The Bone & Joint Journal. :1144-1150 |
| ISSN: | 2049-4408 2049-4394 |
| Popis: | AimsThe aim of this study was to report the results of custom-made endoprostheses with extracortical plates plus or minus a short, intramedullary stem aimed at preserving the physis after resection of bone sarcomas in children.Patients and MethodsBetween 2007 and 2017, 18 children aged less than 16 years old who underwent resection of bone sarcomas, leaving ≤ 5 cm of bone from the physis, and reconstruction with a custom-made endoprosthesis were reviewed. Median follow-up was 67 months (interquartile range 45 to 91). The tumours were located in the femur in 11 patients, proximal humerus in six, and proximal tibia in one.ResultsThe five-year overall survival rate was 78%. No patient developed local recurrence. The five-year implant survival rate was 79%. In all, 11 patients (61%) developed a complication. Seven patients (39%) required further surgery to treat the complications. Implant failures occurred in three patients (17%) including one patient with aseptic loosening and two patients with implant or periprosthetic fracture. The preserved physis continued to grow at mean 3.3 cm (0 to 14). The mean Musculoskeletal Society score was 88% (67% to 97%).ConclusionCustom-made endoprostheses that aim to preserve the physis are a safe and effective option for preserving physeal growth, limb length, and joint function with an acceptable rate of complications. Cite this article: Bone Joint J 2019;101-B:1144–1150 |
| Databáze: | OpenAIRE |
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