title: Surgical management of proximal fibular tumors: A report of 12 cases.
abstract: OBJECTIVE
  Aggressive benign or malignant tumors in the proximal fibula may require en bloc resection of the fibular head, including the peroneal nerve and lateral collateral ligament. Here, we report the treatment outcomes of 12 patients with aggressive benign or malignant proximal fibula tumors.
  
  
  METHODS
  Four patients with osteosarcoma and 1 patient with Ewing's sarcoma were treated with intentional marginal resections after effective chemotherapy, and 4 patients underwent fibular head resections without ligamentous reconstruction. Clinical outcomes were investigated.
  
  
  RESULTS
  The mean Musculoskeletal Tumor Society scores were 96% and 65% in patients without peroneal nerve resection and those with nerve resection, respectively. No patients complained of knee instability.
  
  
  CONCLUSIONS
  Functional outcomes after resection of the fibular head were primarily influenced by peroneal nerve preservation. If patients are good responders to preoperative chemotherapy, malignant tumors may be treated with marginal excision, resulting in peroneal nerve preservation and good function.
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8640, Japan; Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Science, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya-shi, Aichi-ken 467-8601, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Inatani
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8640, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8640, Japan; Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Science, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya-shi, Aichi-ken 467-8601, Japan.
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8640, Japan; Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Science, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya-shi, Aichi-ken 467-8601, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kimura
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8640, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Takeuchi
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8640, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Miwa
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8640, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Higuchi
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8640, Japan.
authors.forename: Kensaku
authors.initials: K
authors.lastname: Abe
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8640, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Taniguchi
authors.affiliation: Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Science, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya-shi, Aichi-ken 467-8601, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Science, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya-shi, Aichi-ken 467-8601, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Okamoto
authors.affiliation: Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Science, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya-shi, Aichi-ken 467-8601, Japan.
authors.forename: Takanobu
authors.initials: T
authors.lastname: Otsuka
authors.affiliation: Department of Orthopaedic Surgery, Kanazawa University Graduate School of Medical Science, 13-1, Takara-machi, Kanazawa-shi, Ishikawa-ken 920-8640, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
keywords: Fibular head resection; Proximal fibular tumor; Reconstruction