title: Pedicle versus free frozen autograft for reconstruction in malignant bone and soft tissue tumors of the lower extremities.
abstract: BACKGROUND
  Of the biological reconstruction methods for malignant bone and soft tissue tumors, reconstruction with liquid nitrogen has the advantage of maintaining continuity on the distal side of the tumor bone site (pedicle freezing procedure; PFP). This method is expected to result in early blood flow recovery, with early union and low complication rate. The purpose of this study was to compare the outcomes of the PFP and free freezing procedure (FFP) in the lower extremities.
  
  
  METHODS
  The study included 20 patients (12 men and 8 women) with frozen autografts (FFP, 13 cases; PFP, 7 cases). The mean age of the subjects was 36.3 years (range 11-79 years), and the mean follow-up period was 56.4 months (range 12-142 months).
  
  
  RESULTS
  Final bone union occurred in 11 patients in the FFP group (84.6%) and in 7 patients in the PFP group (100%). The mean union period in patients who did not need additional surgery was 9.8 months (range 4-21 months) in the FFP group and 4.8 months (range 2-7 months) in the PFP group. Postoperative complications occurred in 8 cases: infection in 3 cases, fracture in 3 cases, and joint destruction in 2 cases. Six FFP patients, and 2 PFP patients (two cases of fracture), developed postoperative complications.
  
  
  CONCLUSIONS
  The union period was shorter and the rate of postoperative complications was lower with the PFP than with the FFP. We considered that early blood flow recovery might have led to the above results in the PFP.
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-8641, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Shimozaki
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: Yoshikazu
authors.initials: Y
authors.lastname: Tanzawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kimura
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takeuchi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Igarashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Inatani
authors.forename: Takashi
authors.initials: T
authors.lastname: Kato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064592:Autografts; D001859:Bone Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005615:Freezing; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013048:Specimen Handling / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult