title: [Applications of external fixation for management of complications associated with musculoskeletal tumors and related surgery].
abstract: OBJECTIVE
  We evaluated the results of, and the course of treatment with, external fixation (EF) in treating complications associated with bone tumors and related surgery.
  
  
  METHODS
  Eighteen patients (9 males, 9 females; mean age 19 years; range 6 to 35 years) who were treated with EF were evaluated in three groups. Histologic diagnoses were osteosarcoma (n=3), Ewing's sarcoma (n=3), hereditary multiple exostosis (n=3), chondrosarcoma (n=2), synovial sarcoma (n=2), Ollier's disease, giant cell tumor of bone, desmoid fibroma, chondromyxoid fibroma, and enchondroma. Complications secondary to bone tumors (n=4) and occurring following limb salvage surgery (n=14) were treated with Ilizarov circular EF in nine patients, unilateral EF in six patients, and both in three patients.
  
  
  RESULTS
  The first group included eight patients who were treated with EF for infection and nonunion or deformity following surgery. The mean shortening was 10.6 cm, the mean lengthening was 9.7 cm, and the mean external fixator index was 48.8 days/cm. One patient developed fracture of the free vascularized fibula graft after EF removal, and amputation was required in two patients. The second group consisted of six patients who had shortening secondary to tumor surgery. The mean shortening was 7.5 cm, the mean lengthening was 6.5 cm, and the mean external fixator index was 28 days/cm. In this group, the major complications were implant failure and knee stiffness. The third group included four patients with deformity and shortening secondary to multiple exostosis (n=3) and Ollier's disease. The mean shortening was 7.5 cm, the mean lengthening was 6.5 cm, and the mean external fixator index was 57.2 days/cm. One patient developed ulnar shortening of 2 cm after growth.
  
  
  CONCLUSIONS
  The use of EF in the management of complications associated with bone tumors and related surgery yields successful results especially in young patients.
authors.affiliation: Department of Orthopedics and Traumatology, Istanbul Medicine Faculty of Istanbul University, Istanbul, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Eralp
authors.forename: Berkin
authors.initials: B
authors.lastname: Toker
authors.forename: Turgut
authors.initials: T
authors.lastname: Akgül
authors.forename: Harzem
authors.initials: H
authors.lastname: Ozger
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kocaoğlu
authors.forename: Sikander
authors.initials: S
authors.lastname: Hayat
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D016267:External Fixators / Q000009:adverse effects*; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D019042:Muscle Neoplasms / Q000601:surgery*; D019857:Osteogenesis, Distraction / Q000379:methods; D012516:Osteosarcoma / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D055815:Young Adult