2002 CTOS Annual Meeting Oral Presentations — Surgery

AUTOBIOLOGICAL RECONSTRUCTION WITH PRESERVED JOINT FUNCTION AFTER SURGICAL TREATMENT OF BONE SARCOMAS IN CHILDREN
[Abstract ID: 42]

Category: Surgery

Presentation: Oral

Authors: Orjan K Berlin¹, Peter Bergh¹, Bjorn Gunterberg¹, Jonas Lundberg², Hans Mark²

Author Institutions: ¹Department of Orthopaedics Sahlgren University Hospital Goteborg, Sweden; ²Department of Plastic Surgery Sahlgren University Hospital Goteborg, Sweden

Presenter: Orjan K Berlin
berbiz@algonet.se

Correspondent: Orjan K Berlin
berbiz@algonet.se
Goteborg Sweden S-413 45
Ph: +46-31-828284
Fax: +46-31-410402

Objectives: After limb-salvage surgery in young children with bone sarcomas our preferences are biologic reconstructions using autologous vascularized fibula grafts. This report describes 3 children in whom the joint function could be preserved in the knee, hip and shoulder joints respectively.

Methods: All 3 patients had clinically good response to preoperative chemotherapy. A 9-year-old girl with an osteosarcoma of the distal femur was reconstructed with dual parallel fibula grafts with the proximal fibula epiphysis towards the knee. The lateral collateral ligaments (LCL) were sutured to the cruciate ligaments. Soft tissue resection was kept to a minimum since it was a stage IIA lesion.

A 9-year-old girl with a stage IIB Ewing sarcoma of the right proximal femur was reconstructed with 2 fibula grafts; one proximal fibula replaced the femoral head and was inserted into the remaining femur, the other graft served as support. The hip-joint capsule was sutured like a pouch around the fibula head.

A 6-year-old girl with a stage IIB telangiectatic osteosarcoma of the left proximal humerus was reconstructed with a single fibula graft. The origin of the long biceps tendon was sutured to the LCL, and the rotator cuff was sutured as a pouch around the fibula head.

Results: 19 months postoperatively the knee reconstruction is ambulatory with a (MSTS) score of 10/30. At 33 months the hip reconstruction is ambulatory with a score of 13/30. At 29 months the shoulder reconstruction has an excellent function with a score of 27/30.

Conclusions: Until now the follw-up results appear encouraging.