title: Mid-term radiological and functional results of biological reconstructions of extremity-located bone sarcomas in children and young adults.
abstract: Biological reconstruction is a useful option for reconstruction following bone sarcoma resection in children. The mid-term functional and radiological outcomes of biological reconstructions after resection of bone sarcomas in children are presented in this study. Eighteen patients [average age 12.5 years (range 4-22 years)] with primary sarcomas of long bones underwent wide surgical resection and biological reconstruction. The bone defects were managed by intercalary (n=14), osteoarticular (n=3) reconstructions and arthrodesis (n=1) with a vascularized fibular graft (VFG). VFG was combined with a massive allograft in seven lower extremity reconstructions. The average follow-up was 45.7 months (range 25-78 months). Graft union and graft hypertrophy was observed in 17 (94.4%) of 18 patients at 12 months. The VFG-allograft osteointegration rate was 100% at 24 months. The average final follow-up Musculoskeletal Tumor Society (MSTS) scores for lower and upper extremity reconstructions were 79.7% (range 66.6-90%) and 80.9% (range 53.3-100%), respectively. Four (22.2%) complications, including nonunion (n=1), implant failure (n=1), infection (n=1) and skin necrosis (n=1), required reoperation. The disease relapsed in three (16.6%) patients. Defect size and VFG length did not correlate with MSTS scores and radiological parameters (P>0.05). Biological reconstruction with VFG can provide permanent stability and progressively increasing functional and radiological results.
authors.affiliation: aDepartment of Orthopaedics and Traumatology, Marmara University Hospital bDepartment of Orthopaedics and Traumatology, Lutfiye Nuri Burat State Hospital cDepartment of Orthopaedics and Traumatology, Acibadem Maslak Hospital, Istanbul dDepartment of Orthopaedics and Traumatology, Dokuz Eylul University Hospital, Izmir eDepartment of Orthopaedics and Traumatology, Sakarya Research and Training Hospital, Sakarya, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Erol
authors.forename: Onur
authors.initials: O
authors.lastname: Basci
authors.forename: Mert Osman
authors.initials: MO
authors.lastname: Topkar
authors.forename: Baris
authors.initials: B
authors.lastname: Caypinar
authors.forename: Hakan
authors.initials: H
authors.lastname: Basar
authors.forename: Cihangir
authors.initials: C
authors.lastname: Tetik
mesh_terms: D000293:Adolescent; D000328:Adult; D050280:Arm Bones / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007867:Leg Bones / Q000601:surgery*; D008297:Male; D012516:Osteosarcoma / Q000601:surgery*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D017211:Treatment Failure; D055815:Young Adult