title: Proximal fibula resection in the treatment of bone tumours.
abstract: OBJECTIVE
  We present a large study of patients with proximal fibula resection. Moreover we describe a new classification system for tumour resection of the proximal fibula independent of the tumour differentiation.
  
  
  METHODS
  In 57 patients the functional and clinical outcomes were evaluated. The follow-up ranged between six months and 22.2 years (median 7.2 years). The indication for surgery was benign tumours in ten cases and malignant tumours in 47 cases. In 13 of 45 patients, where a resection of the lateral ligament complex was done, knee instability occurred. In 32 patients a resection of the peroneal nerve with resulting peroneal palsy was necessary.
  
  
  RESULTS
  Patients with peroneal resection had significantly worse functional outcome than patients without peroneal resection. An ankle foot orthosis was tolerated well by these patients. Three of four patients with pathological tibia fracture had local radiation therapy. There was no higher risk of tibia fracture in patients with partial tibial resection.
  
  
  CONCLUSIONS
  Resection of tumours in the proximal fibula can cause knee instability, peroneal palsy and in cases of local radiation therapy, a higher risk of delayed wound healing and fracture. Despite the risks of proximal fibula resection, good functional results can be achieved.
authors.affiliation: Department of Orthopaedics and Tumour Orthopaedics, University Hospital of Münster, Albert-Schweitzer-Straße 33, 48149, Münster, Germany. Ralf.Dieckmann@ukmuenster.de
authors.forename: Ralf
authors.initials: R
authors.lastname: Dieckmann
authors.forename: Carsten
authors.initials: C
authors.lastname: Gebert
authors.forename: Arne
authors.initials: A
authors.lastname: Streitbürger
authors.forename: Marcel-Philipp
authors.initials: MP
authors.lastname: Henrichs
authors.forename: Uta
authors.initials: U
authors.lastname: Dirksen
authors.forename: Robert
authors.initials: R
authors.lastname: Rödl
authors.forename: Georg
authors.initials: G
authors.lastname: Gosheger
authors.forename: Jendrik
authors.initials: J
authors.lastname: Hardes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D002648:Child; D017885:Collateral Ligaments / Q000601:surgery; D005260:Female; D005360:Fibula / Q000473:pathology / Q000601:surgery*; D050723:Fractures, Bone; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000209:etiology / Q000473:pathology; D010543:Peroneal Nerve / Q000293:injuries / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications; D011878:Radiotherapy / Q000009:adverse effects; D020127:Recovery of Function; D012189:Retrospective Studies; D014945:Wound Healing / Q000528:radiation effects; D055815:Young Adult