Expandable endoprosthesis for limb-sparing surgery in children: long-term results
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- 作者：Amit Dotan (1)
Shlomo Dadia (1)
Jacob Bickels (1)
Alexander Nirkin (1)
Gideon Flusser (1)
Josephin Issakov (1)
Yoram Neumann (2)
Ian Cohen (3)
Myriam Ben-Arush (4)
Yehuda Kollender (1)
Isaac Meller (1) - 关键词：Bone sarcoma ; Expandable endoprosthesis ; Limb ; sparing surgery (LSS) ; Limb length discrepancy (LLD)
- 刊名：Journal of Children's Orthopaedics
- 出版年：2010
- 出版时间：October 2010
- 年：2010
- 卷：4
- 期：5
- 页码：391-400
- 全文大小：484KB
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Shlomo Dadia (1)
Jacob Bickels (1)
Alexander Nirkin (1)
Gideon Flusser (1)
Josephin Issakov (1)
Yoram Neumann (2)
Ian Cohen (3)
Myriam Ben-Arush (4)
Yehuda Kollender (1)
Isaac Meller (1)
1. The National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center, 6 Weizmann St., 64239, Tel-Aviv, Israel
2. Department of Pediatric Hematology Oncology, The Sheba Medical Center, Tel-Hashomer, Israel
3. Center for Pediatric Hematology Oncology, Schneider Children’s Medical Center of Israel, Petach Tikvah, Israel
4. Department of Pediatric Hematology Oncology, Meyer Children’s Hospital, Rambam Health Care Campus, The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
文摘
Purpose Most children today with bone sarcomas undergo limb-sparing surgery. When treating children younger than 12 years of age, the result is significant limb length discrepancy (LLD). One of the solutions is the use of an expandable endoprosthesis. Methods A retrospective analysis of 38 skeletally immature patients with bone sarcoma of the lower limb in whom different types of expandable endoprostheses were used from January 1988 to December 2005 were included. All patients were under the age of 14 years. There were 26 osteosarcoma and 12 Ewing’s sarcomas. The data collected included the tumor characteristics, the surgical and other treatment modalities, complications and their treatment, and the final LLD and functional results. Results Fifty-five percent of the patients survived and had a mean follow-up of 113?months. All survivors reached skeletal maturity at the time of last follow-up. Seventy-one percent of the survivors had satisfactory function and 29% had a poor result. There were three secondary amputations due to local recurrence. Complications were documented in 58% of patients; the most common was infection that was diagnosed 56 times (primary 16% and secondary 84%). A significant correlation was found between function and final LLD (greater than 5?cm?=?inferior function), the number of complications, and the number of surgical procedures performed other than prosthesis elongation. The younger the patient was at definitive surgery, the shorter the time it took for the prosthesis to fail. Conclusion In order to improve results, the number of operations must be reduced. This can be achieved by the use of novel non-invasive expandable endoprostheses or biological reconstruction.