The management of limb-length discrepancies in children after treatment of osteosarcoma and Ewing's sarcoma.
The authors present 15 cases of discrepancy of the lower limbs > 5 cm, in children in whom the histological diagnosis was Ewing's sarcoma or osteosarcoma, who were treated using polychemotherapy or radiotherapy or both in some cases and limb-salvage surgery. Ten of these patients required compensation for discrepancy by limb lengthening. In three patients, a second lengthening had to be carried out. A shortening of the contralateral femur was performed in two cases, and in another two, a femur-tibia epiphysiodesis was done. The average lengthening achieved was 8.1 cm with a healing index of 41 days/cm. Leg-length discrepancy in the treatment of sarcomas of the musculoskeletal system is an important sequela, especially when treating children. Compensation for this can be obtained by lengthening healthy bone, with a complication rate similar to that of other etiologies. The difference compensated depends on the biological capacity of bone regeneration of the individual and, therefore, is a definitive solution.
González-Herranz
P
P
Pediatric Orthopedic Service, Hospital Ramon y Cajal, Universidad de Alcala de Henares, Madrid, Spain.
Burgos-Flores
J
J
Ocete-Guzmán
J G
JG
López-Mondejar
J A
JA
Amaya
S
S
D000293:Adolescent; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D012516:Osteosarcoma / Q000628:therapy*; D011183:Postoperative Complications / Q000601:surgery*; D011859:Radiography; D012512:Sarcoma, Ewing / Q000000981:diagnostic imaging / Q000628:therapy*; D013977:Tibia; D016896:Treatment Outcome