title: Over 10-year follow-up of functional outcome in patients with bone tumors reconstructed using distraction osteogenesis.
abstract: BACKGROUND
  The aim of this study was to investigate the long-term functional capabilities of patients who underwent bone distraction for the treatment of bone defects caused by bone tumor excision.
  
  
  METHODS
  Bone distraction was indicated for patients with stage IIB malignant bone tumors when chemotherapy was judged to be effective and an epiphysis could be preserved or for patients with low-grade or aggressive benign bone tumors. Twenty-two patients who underwent reconstruction with bone distraction and were followed up for at least 10 years were retrospectively investigated. Patients included 8 males and 14 females, with a mean age of 25.3 years. Tumor types included seven osteosarcomas, two osteofibrous dysplasias, one Ewing's sarcoma, five low-grade osteosarcomas, two adamantinomas, and five giant cell tumors. Chemotherapy was performed during bone distraction in 8 cases. Bone transport was used in 17 cases, while shortening distraction was used in 5 cases.
  
  
  RESULTS
  The mean distraction length was 8.1 cm, and the mean external fixation period was 301 days. The average Musculoskeletal Tumor Society score (used to measure functional outcome) was 91.5 % at mean follow-up of 202 months. Fourteen patients were able to play sports without any difficulty.
  
  
  CONCLUSIONS
  Epiphyseal preservation and reconstruction by bone distraction require both time and effort, but can provide excellent long-term outcomes, resulting in a stable reconstruction that functionally restores the natural limb.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Watanabe
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
authors.forename: Norio
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Shirai
authors.forename: Hideji
authors.initials: H
authors.lastname: Nishida
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Hayashi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takeuchi
authors.forename: Hidenori
authors.initials: H
authors.lastname: Matsubara
authors.forename: Issei
authors.initials: I
authors.lastname: Nomura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015444:Exercise / Q000502:physiology*; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult