[Surgical treatment of locally aggressive and malignant tumors of the proximal third of the fibula. Oncology results and functional evaluation].
BACKGROUND
Proximal fibula malignant and locally aggressive benign bone tumors are uncommon and usually treat by surgery. Bloc resection of the knee can compromise knee stability due to of the resection of the posterolateral ligament complex.


METHODS
We analyzed 28 consecutive patients treated for a proximal fibula bone tumor between 1980 and 2006 (osteosarcoma: 9, giant cell tumor: 9, Ewing sarcoma: 8 and chondrosarcoma: 2). Sixty-one percent were male and the median age was 21 years (range: 8-60). The mean follow-up was 86 months. The posterolateral complex was reinserted at tibial metaphyseal level. Patients were evaluated functionally using the Musculoskeletal Tumor Society scale (MSTS).


RESULTS
Overall survival rate was 89%, local recurrence rate was 11%, and secondary amputation rate was 6% at 7 years of median follow-up. The average MSTS score was 93%. Five patients had neurological complications. No patient experienced subjective instability or vascular insufficiency.


CONCLUSIONS
Bloc resection of the proximal fibula for the treatment of aggressive or malignant primary bone tumors allowed us to obtain local tumor control, and overall survival rate for sarcomas of 89% at 7 years. The posterolateral ligament complex tibial reinsertion provided functional knee stability without major functional consequences in the medium term.
Ortopedia y Traumatología, Sector de Ortopedia Oncológica y Trasplantes Óseos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
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GL
Farfalli
Ortopedia y Traumatología, Sector de Ortopedia Oncológica y Trasplantes Óseos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: Jose.albergo@hiba.org.ar.
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JI
Albergo
Ortopedia y Traumatología, Sector de Ortopedia Oncológica y Trasplantes Óseos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
M A
MA
Ayerza
Ortopedia y Traumatología, Sector de Ortopedia Oncológica y Trasplantes Óseos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
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DL
Muscolo
Ortopedia y Traumatología, Sector de Ortopedia Oncológica y Trasplantes Óseos, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
L A
LA
Aponte-Tinao
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D005360:Fibula / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D055815:Young Adult
Block resection; Complejo posterolateral; Fibula; Peroné; Posterolateral ligament complex; Resección en bloque; Sarcoma; Sarcomas