title: Successful correction of tibial bone deformity through multiple surgical procedures, liquid nitrogen-pretreated bone tumor autograft, three-dimensional external fixation, and internal fixation in a patient with primary osteosarcoma: a case report.
abstract: BACKGROUND
  In a previous report, we described a method of reconstruction using tumor-bearing autograft treated by liquid nitrogen for malignant bone tumor. Here we present the first case of bone deformity correction following a tumor-bearing frozen autograft via three-dimensional computerized reconstruction after multiple surgeries.
  
  
  METHODS
  A 16-year-old female student presented with pain in the left lower leg and was diagnosed with a low-grade central tibial osteosarcoma. Surgical bone reconstruction was performed using a tumor-bearing frozen autograft. Bone union was achieved at 7 months after the first surgical procedure. However, local tumor recurrence and lung metastases occurred 2 years later, at which time a second surgical procedure was performed. Five years later, the patient developed a 19° varus deformity and underwent a third surgical procedure, during which an osteotomy was performed using the Taylor Spatial Frame three-dimensional external fixation technique. A fourth corrective surgical procedure was performed in which internal fixation was achieved with a locking plate. Two years later, and 10 years after the initial diagnosis of tibial osteosarcoma, the bone deformity was completely corrected, and the patient's limb function was good.
  
  
  CONCLUSIONS
  We present the first report in which a bone deformity due to a primary osteosarcoma was corrected using a tumor-bearing frozen autograft, followed by multiple corrective surgical procedures that included osteotomy, three-dimensional external fixation, and internal fixation.
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. a_take@med.kanazawa-u.ac.jp.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takeuchi
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. norinori@med.kanazawa-u.ac.jp.
authors.forename: Norio
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: Department of Orthopedic Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. shirai.t77@gmail.com.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Shirai
authors.affiliation: Department of Orthopedic Surgery, Kanazawa Seirei Hospital, Kanazawa, Japan. hideji0511@yahoo.co.jp.
authors.forename: Hideji
authors.initials: H
authors.lastname: Nishida
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. hayashikatsu830@aol.com.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Department of Orthopedic Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan. nabechov@sf7.so-net.ne.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. miwapoti@yahoo.co.jp.
authors.forename: Shinji
authors.initials: S
authors.lastname: Miwa
authors.affiliation: Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan. tsuchi@med.kanazawa-u.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000293:Adolescent; D064592:Autografts; D001859:Bone Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods*; D015925:Cryopreservation / Q000379:methods; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D005598:Fractures, Spontaneous / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D009584:Nitrogen; D012516:Osteosarcoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D010027:Osteotomy / Q000379:methods*; D012086:Reoperation; D013977:Tibia; D013978:Tibial Fractures / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014182:Transplantation, Autologous
chemical_list: D009584:Nitrogen