Proximal fibula resection in the treatment of bone tumours

Dieckmann, Ralf; Gebert, Carsten; Streitbürger, Arne; Henrichs, Marcel-Philipp; Dirksen, Uta; Rödl, Robert; Gosheger, Georg; Hardes, Jendrik

doi:10.1007/s00264-010-1193-3

Cited by 23 publications

(38 citation statements)

References 26 publications

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“…The main therapeutic challenges, in addition to eradication of the lesion, are to avoid local recurrence, prevent damage to the growth plate, maintain fibular length, avoid progressive valgus deformity of the ankle and preserve stability of the ankle and the knee [4][5][6]. The close relation of the common peroneal nerve, the anterior tibial artery and the lateral collateral ligament to the proximal fibula are major concerns in the surgical management of proximal fibular tumors [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Subperiosteal resection of fibular aneurysmal bone cyst

Mostafa

2014

Eur J Orthop Surg Traumatol

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Aneurysmal bone cyst (ABC) of the fibula poses a challenge as to the most appropriate treatment particularly in children and adolescents. A prospective study was conducted to evaluate the results of subperiosteal resection of fibular ABCs. Eleven patients (six boys and five girls) with an average age of 12.4 years (6-18 years) were treated by subperiosteal resection of ABC of the fibula. The lesion was juxtaphyseal in three patients (two distal and one proximal), metaphyseal in seven and diaphyseal in one. All cysts were active and centrally located type 2. The modified Enneking scoring system was used for final functional evaluation while a scale proposed by the author was used for final radiological assessment. At the final follow-up, there was no difference in the range of movement, alignment or stability of the ankle or the knee when compared with the opposite side. Three patients complained of mild discomfort on heavy activity. One patient had failure of healing that was related to the use of suction drain. After a mean follow-up of 41.6 months (24-64 months), the mean functional score was 98.8% (93-100%). According to the proposed radiological scale, six patients were rated excellent, three good, one fair and one poor. In conclusion, subperiosteal resection is effective in eradicating fibular ABCs, regenerates a new bone and avoids the morbidity of other techniques.

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Section: Introductionmentioning

confidence: 99%

Subperiosteal resection of fibular aneurysmal bone cyst

Mostafa

2014

Eur J Orthop Surg Traumatol

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“…The MSTS scores of surgically treated benign and malignant proximal fibular tumors are available in the literature. Dieckmann et al [8] reported the mean MSTS scores as 90 to 97% for 57 patients with 46 malignant tumors who had undergone fibular resection for benign or malign tumors between 1987 and 2009. Inatani et al [9] reported 12 patients with benign or malignant tumors who underwent surgery between 1992 and 2011 and indicated the mean MSTS score as 96% (range, 70% and 100%) for those in whom peroneal nerve could not be resected and as 65% (range, 60% and 70%) for those in whom the nerve was resected.…”

Section: Discussionmentioning

confidence: 99%

“…An updated review of the literature regarding tumors in the proximal fibula is provided in Table II. [1][2][3][6][7][8][9]13,14] Malawer type 1 and type 2 resection is an effective surgical treatment method for tumors diagnosed early, not reaching large sizes, and with no tibial metastasis.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of primary malignant proximal fibular tumors: Functional and clinical outcomes of 23 patients

Atalay

Yılmaz

Korkmaz

et al. 2019

Eklem Hastalik Cerrahisi

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Amaç: Bu çalışmada proksimal fibula yerleşimli primer malign tümörlü hastaların klinik özellikleri ve tedavi sonuçları değerlendirildi. Hastalar ve yöntemler: Bu retrospektif çalışmaya Mayıs 2007 ve Mayıs 2017 tarihleri arasında proksimal fibula yerleşimli primer malign tümörü olan 23 hasta (15 erkek, 8 kadın; ort. yaş 22.1 yıl; dağılım, 9-63 yıl) dahil edildi. Tüm hastaların anamnez veya tıbbi öyküsü, fiziksel muayenesi, düz göğüs grafisi, akciğer bilgisayarlı tomografisi, etkilenen ekstremitesinin direkt grafisi ve manyetik rezonans görüntülemesi ve rutin laboratuvar testleri değerlendirildi. Bulgular: Hastaların 11'ine osteosarkom (%47.8), dokuzuna Ewing sarkomu (%39.1), ikisine kondrosarkom (%8.7) ve birine (%4.3) sinovyal sarkom tanısı konuldu. Ağrı ve palpabl kitle en sık görülen semptomlardı. Tanı anında altı hastada akciğer metastazı vardı. Hastaların sekizine Malawer tip 1 rezeksiyon (%34.8), dokuzuna tip 2 rezeksiyon (%39.1), dördüne diz üstü amputasyon (%17.4) ve ikisine proksimal tibia tümör rezeksiyon protezi (%8.6) uygulandı. Ortalama takip süresi 36 ay (dağılım, 12-119 ay) idi. Üç hastada lokal nüks gelişti. Tüm hastaların ortalama Musküloskeletal Tümör Cemiyeti (MSTC) skoru 62 idi. Sonuç: Proksimal fibulanın primer malign tümörlerinin cerrahi tedavisi problemlidir. Uygun endikasyonlarda, Malawer tip 1 rezeksiyon daha düşük lokal nüks oranları ve daha yüksek MSTC skorları nedeniyle tercih edilen tedavi olmalıdır.

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“…Obtaining at least two distal perforators, the LHBFM can also be used as 180° turnover flap for coverage of wounds around the knee joint [ 51 , 56 ]. The loss of function after separation of LHBFM is sufficiently remedied by the other ischio-crural muscles provided that they are not damaged and there is also no preexistent lateral instability in knee joint; hence, the possible postoperative loss of function and lateral knee laxity would be of relevance for athletes [ 57 - 60 ].…”

Section: Discussionmentioning

confidence: 99%

A Devasting Course of an Iliopsoas Muscle Abscess Subsequently Leading to Septic Shock, Septic Hip Arthritis, and Extended Gluteal Soft Tissue Necroses in an Elderly Immunocompromised Patient with Multiple Carcinomas: A Case Report and Brief Review of Literature

Schmidt¹

2018

TOORTHJ

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Background:A devasting course of Iliopsoas Muscle (IPM) abscess remains a challenging therapeutic problem.Methods:A 69-year-old polymorbid male had a history of multiple carcinomas and presented with advanced stage of septic shock due to a right IPM abscess which communicated with the right hip joint and subsequently led to septic hip arthritis accompanied with post-infectious right gluteal deep soft tissue necroses. Management of surgical treatment included abscess revision, coverage with the use of Long Head Biceps Femoris Muscle (LHBFM) 180° turnover flap, and creating a Girdlestone resection-arthroplasty.Results:After a duration of patient's hospitalization of six months that included the necessity of artificial respiration over two months accompanied with in summary 18 required surgical procedures, the patient could be recovered successfully regarding his polymorbidity and his low-demand claims in activities of daily living with his Girdlestone resection-arthroplasty.Conclusion:Recovery of immunocompromised patients with those life-threatening situations can only be achieved by an interdisciplinary management. The LHBFM 180° turnover flap can be useful for filling off post-infectious deep soft tissue cavities communicating with the hip joint. The definitive Girdlestone resection-arthroplasty for treatment of septic hip arthritis is the method of choice for mobilization of elderly polymorbid patients with low demand claims in their activities of daily living.

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Proximal fibula resection in the treatment of bone tumours

Cited by 23 publications

References 26 publications

Subperiosteal resection of fibular aneurysmal bone cyst

Subperiosteal resection of fibular aneurysmal bone cyst

Surgical management of primary malignant proximal fibular tumors: Functional and clinical outcomes of 23 patients

A Devasting Course of an Iliopsoas Muscle Abscess Subsequently Leading to Septic Shock, Septic Hip Arthritis, and Extended Gluteal Soft Tissue Necroses in an Elderly Immunocompromised Patient with Multiple Carcinomas: A Case Report and Brief Review of Literature

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