title: [The survival and functional outcome of primary bone sarcomas in distal lower extremity].
abstract: OBJECTIVE
  To analyze the oncological and functional outcome of limb salvage in this location.
  
  
  METHODS
  From November 2003 to January 2010, 20 patients with primary malignant bone tumors of the distal lower extremity were treated. There were 15 male and 5 female, the mean age was 20 years. Among 14 patients with malignant distal tibial sarcoma, 11 patients had ankle arthrodesis reconstructed by using allograft (7 patients) or autografts (4 patients), the other 3 patients underwent below-knee amputation. Three patients with osteosarcoma of distal fibula reconstructed with ipsilateral fibular head, 3 patients with calcaneus osteosarcoma underwent total calcanectomy and reconstructed with fibular segment and iliac crest. The mean follow-up was 36.4 months.
  
  
  RESULTS
  Five of 7 (71.4%) patients with allograft reconstruction were associated with delayed wound healing, however, only 1 of 10 patients with autograft had this problem (P = 0.036). One local recurrence was observed, 2 osteosarcoma patients died of disseminated disease. The estimated 2-year and 5-year overall survival for the patients with malignant tibial sarcomas were 92.9% and 79.6% respectively, for the patients with distal tibial high-grade osteosarcoma were 87.5% and 70.0% respectively. The mean functional MSTS score was 82% for limb salvage patients.
  
  
  CONCLUSIONS
  The survival of patients with primary malignant bone tumor of distal lower extremity seems to be better than that of other sites. Limb salvage can provide satisfactory local control and functional results.
authors.affiliation: Orthopaedic Oncology Department, People's Hospital, Peking University, Beijing 100044, China.
authors.forename: Tai-qiang
authors.initials: TQ
authors.lastname: Yan
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.forename: Rong-li
authors.initials: RL
authors.lastname: Yang
authors.forename: Xin
authors.initials: X
authors.lastname: Sun
authors.forename: Hua-yi
authors.initials: HY
authors.lastname: Qu
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult