[The application of transposition of the gastrocnemius muscle in the limb-salvage operations of the proximal tibial tumors].
OBJECTIVE
To evaluate the efficacy of transposition of the gastracnemius muscle in the limb-salvage operation of the proximal tibial tumor.


METHODS
From 1995, transposition of the gastrocnemius muscle was applied to cover the devitalized bone, bone cement or autologous bone graft in 15 cases with tumors of the proximal tibia (transposition of medial heads of gastrocnemius muscle in 12 cases, and lateral heads of gastrocnemius muscle in 3 cases respectively). Among them, there were 7 osteosarcomas, 5 giant cell tumors, 1 malignant fibrous histocytoma, 1 chondrosarcoma and 1 osteoblastoma. The operations included segmental devitalization with 95% alcohol in 7 cases, knee reconstruction of the unilateral tibial plateau with iliac graft in 5 cases, segmental devitalization with microwave in 2 cases, local resection and bone graft in 1 cases.


RESULTS
Apart from 2 cases whose wounds needed suturing again due to the liquefaction of the subcutaneous fat around the incision, no wound complications were occured in other 13 patients. No significant loss in the function of the leg and ankle was observed after transposition of the gastrocnemius muscle. There was no local recurrence, but 3 patients died due to lung metastases.


CONCLUSIONS
Transposition of the gastrocnemius muscle after resection of promixal tibial tumors can improve the local blood supply, cover the deep structures and prevent from the failure of limb-salvage operation due to wound complications.
Li
J M
JM
Department of Orthopedic Surgery, Affiliated Hospital, Shandong Medical University, Jinan Shandong, P. R. China, 250012.
Yang
Z P
ZP
Jia
Y H
YH
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply / Q000601:surgery*; D012516:Osteosarcoma / Q000601:surgery; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D013977:Tibia