title: Successful management of a childhood osteosarcoma with epiphysiolysis and distraction osteogenesis.
abstract: In an 11-year-old boy with osteosarcoma in the proximal tibia (type iii), 2 cycles of dia chemotherapy (cisplatin, ifosfamide, doxorubicin) were administered preoperatively while epiphysiolysis was performed. Clinical response was determined to be complete by radiography and histopathology. Marginal excision was then performed with preservation of the proximal tibial epiphysis. Metaphyseal reconstruction was performed using distraction osteogenesis. Six cycles of dia chemotherapy were administered postoperatively. Twenty months later, the patient had developed no complications and experienced full bone healing, with no limb discrepancy. In selected adolescent patients with osteosarcoma, in whom the tumour is in full contact with the epiphysis, epiphyseal preservation by epiphysiolysis and reconstruction by distraction osteogenesis can provide an excellent outcome, resulting in a stable reconstruction that functionally restores the native limb.
authors.affiliation: Orthopaedic Department, General Hospital of Jinan Military Region, Jinan, PR China.
authors.forename: S F
authors.initials: SF
authors.lastname: Xu
authors.affiliation: Orthopaedic Department, General Hospital of Jinan Military Region, Jinan, PR China.
authors.forename: X C
authors.initials: XC
authors.lastname: Yu
authors.affiliation: Orthopaedic Department, General Hospital of Jinan Military Region, Jinan, PR China.
authors.forename: M
authors.initials: M
authors.lastname: Xu
authors.affiliation: Department of Orthopaedic Surgery, Tangdu Hospital, Xi'an, PR China.
authors.forename: X
authors.initials: X
authors.lastname: Chen
keywords: Osteosarcoma; distraction osteogenesis; epiphysiolysis; epiphysis preservation; limb function; quality of life
references.citation: J Pediatr Orthop. 1999 Jul-Aug;19(4):543-8
references.pmid: 10413011
references.citation: Vestn Khir Im I I Grek. 1969 Jun;102(6):77-84
references.pmid: 4904826
references.citation: J Bone Joint Surg Am. 2005 Sep;87 Suppl 1(Pt 2):226-36
references.pmid: 16140796
references.citation: Clin Orthop Relat Res. 1991 Sep;(270):264-70
references.pmid: 1884548
references.citation: Plast Reconstr Surg. 1984 May;73(5):741-50
references.pmid: 6371860
references.citation: J BUON. 2011 Oct-Dec;16(4):617-26
references.pmid: 22331712
references.citation: Cancer. 1982 Mar 15;49(6):1221-30
references.pmid: 6174200
references.citation: J Bone Joint Surg Br. 1994 Jan;76(1):127-32
references.pmid: 8300655
references.citation: Lancet Oncol. 2003 Jun;4(6):343-50
references.pmid: 12788406
references.citation: AJR Am J Roentgenol. 1996 Nov;167(5):1211-5
references.pmid: 8911182
references.citation: J Bone Joint Surg Am. 2004 Dec;86(12):2686-93
references.pmid: 15590854
references.citation: Arch Orthop Trauma Surg. 2010 Apr;130(4):489-95
references.pmid: 19440722
references.citation: J Bone Joint Surg Br. 2002 Nov;84(8):1162-6
references.pmid: 12463663
references.citation: Clin Orthop Relat Res. 1991 Mar;(264):156-68
references.pmid: 1997230
references.citation: J Bone Joint Surg Br. 2008 Jul;90(7):924-8
references.pmid: 18591604
references.citation: J Orthop Trauma. 2007 Oct;21(9):634-42
references.pmid: 17921839
references.citation: Clin Orthop Relat Res. 1993 Jan;(286):241-6
references.pmid: 8425352
references.citation: J Reconstr Microsurg. 2001 Jan;17(1):17-25
references.pmid: 11316280
references.citation: Orthop Surg. 2009 Aug;1(3):196-202
references.pmid: 22009842
references.citation: J Orthop Sci. 2004;9(6):638-42
references.pmid: 16228685