title: Reconstruction of segmental bone defect of long bones after tumor resection by devitalized tumor-bearing bone.
abstract: BACKGROUND
  The reconstruction of an intercalary bone defect after a tumor resection of a long bone remains a challenge to orthopedic surgeons. Though several methods have been adopted to enhance the union of long segmental allografts or retrieved segmental autografts to the host bones, still more progresses are required to achieve a better union rate. Several methods have been adopted to devitalize tumor bone for recycling usage, and the results varied. We describe our experiences of using devitalized tumor-bearing bones for the repairing of segmental defects after tumor resection.
  
  
  METHODS
  Twenty-seven eligible patients treated from February 2004 to May 2012 were included. The segmental tumor bone (mean length, 14 cm) was resected, and then devitalized in 20% sterile saline at 65 °C for 30 min after the tumor tissue was removed. The devitalized bone was implanted back into the defect by using nails or plates.
  
  
  RESULTS
  Complete healing of 50 osteotomy ends was achieved at a median time of 11 months (interquartile range (IQR) 9-13 months). Major complications included bone nonunion in four bone junctions (7.4%), devitalized bone fracture in one patient (3.7%), deep infection in three patients (11.1%), and fixation failure in two patients (7.4%). The bone union rates at 1 and 2 years were 74.1 and 92.6%, respectively. The average functional score according to the Musculoskeletal Tumor Society (MSTS) 93 scoring system was 93 % (IQR 80-96.7%).
  
  
  CONCLUSIONS
  Incubation in 20% sterile saline at 65 °C for 30 min is an effective method of devitalization of tumor-bearing bone. The retrieved bone graft may provide as a less expensive alternative for limb salvage. The structural bone and the preserved osteoinductivity of protein may improve bone union.
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, Beijing, 100044, China. wwwquhuayi@163.com.
authors.forename: Huayi
authors.initials: H
authors.lastname: Qu
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, Beijing, 100044, China. bonetumor@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Guo
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, Beijing, 100044, China. yrlyt@sohu.com.
authors.forename: Rongli
authors.initials: R
authors.lastname: Yang
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, Beijing, 100044, China. laedasen@163.com.
authors.forename: Dasen
authors.initials: D
authors.lastname: Li
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, Beijing, 100044, China. tangshun@vip.126.com.
authors.forename: Shun
authors.initials: S
authors.lastname: Tang
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, Beijing, 100044, China. 13701312827@163.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, Beijing, 100044, China. dongsen@189.cn.
authors.forename: Sen
authors.initials: S
authors.lastname: Dong
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, Beijing, 100044, China. bonesarcomajay@163.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Zang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000379:methods*; D012512:Sarcoma, Ewing / Q000473:pathology / Q000601:surgery*; D055815:Young Adult