title: Reconstruction after wide resection of the entire distal fibula in malignant bone tumours.
abstract: In this study we present a series of patients (n = 11) with resection of the entire distal fibula in the case of sarcoma or metastasis. Moreover, we describe a new method to restore ankle stability with a tibiotalocalcaneal arthrodesis using a retrograde hindfoot nail (n = 4) in contrast to tibiotalar arthrodesis with screws (n = 5). The screw fixation failed in two patients due to osteopoenic bone. The crucial benefits of an arthrodesis with a retrograde nail are a stable arthrodesis, intramedullary stabilisation of the tibia and avoidance of extrinsic material in the wound area. An arthrodesis with a retrograde nail is a good alternative for reconstruction after a wide distal fibula resection. The additional arthrodesis of the subtalar joint was not associated with worse functional results in the MSTS and TESS scores.
authors.affiliation: Department of Orthopaedics and Tumour Orthopaedics, University Hospital Muenster, Muenster, Germany. Ralf.Dieckmann@ukmuenster.de
authors.forename: Ralf
authors.initials: R
authors.lastname: Dieckmann
authors.forename: Helmut
authors.initials: H
authors.lastname: Ahrens
authors.forename: Arne
authors.initials: A
authors.lastname: Streitbürger
authors.forename: Tymoteusz Borys
authors.initials: TB
authors.lastname: Budny
authors.forename: Marcel-Philipp
authors.initials: MP
authors.lastname: Henrichs
authors.forename: Volker
authors.initials: V
authors.lastname: Vieth
authors.forename: Carsten
authors.initials: C
authors.lastname: Gebert
authors.forename: Jendrik
authors.initials: J
authors.lastname: Hardes
mesh_terms: D000843:Ankle Joint / Q000601:surgery; D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D001858:Bone Nails; D001859:Bone Neoplasms / Q000601:surgery*; D001863:Bone Screws; D002111:Calcaneus / Q000601:surgery; D005260:Female; D005360:Fibula / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D008297:Male; D012516:Osteosarcoma / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000601:surgery*