Resection-shortening-distraction for malignant bone tumours. A report of two cases

Said, Galal Z.; El-Sherif, Essam

doi:10.1302/0301-620x.77b2.7706329

Cited by 22 publications

(10 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Ilizarov method is widely used for reconstruction of the proximal tibia in the treatment of fractures, nonunion, traumatic bone defects, osteomyelitis and deformity (Ilizarov 1991;Maiocchi and Aronson 1991), but there are few reports of the use of distraction osteogenesis in the management of bone tumours (Stoffelen, Lammens and Fabry 1993; Tsuchiya et al 1993;Caña-dell, Forriol and Cara 1994;Said and El-Sherif 1995). Methylmethacrylate has been utilised, but low-grade radiological osteoarthritis was found in two of 14 patients with a giant-cell tumour treated by curettage and cement (Persson et al 1984).…”

Section: Discussionmentioning

confidence: 99%

The Ilizarov Method in the Management of Giant-Cell Tumours of the Proximal Tibia

Tsuchiya¹,

Tomita²,

Shinokawa³

et al. 1996

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

We have used the Ilizarov technique for the management of subarticular defects after the excision of giant-cell tumours in the proximal tibia in five patients. The defect was reconstructed with a segment of 5 to 6 cm obtained from the diaphysis of the affected tibia and by autogenous bone graft from the iliac crest. The newly developed defect in the diaphysis was reconstructed by distraction using the Ilizarov apparatus. Bone grafting at the docking site was performed soon after positioning the bone segments.The mean length of the bone defect was 5.7 cm and the mean duration of external fixation was 233 days. The relative blood flow in the leg measured by 99m Tc angiography increased by 1.7 to 2.3 times that of the control level during distraction and consolidation. When seen at a mean of 43 months all patients showed a normal range of motion in the knee and ankle with no collapse of the articular surfaces.

show abstract

Section: Discussionmentioning

confidence: 99%

The Ilizarov Method in the Management of Giant-Cell Tumours of the Proximal Tibia

Tsuchiya¹,

Tomita²,

Shinokawa³

et al. 1996

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

show abstract

“…Since timing is crucial, the prediction of remaining growth and final leg length discrepancy is a condition sine qua non [68,69]. Acute shortening by bone resection followed by gradual lengthening is a possible strategy for complex fractures, infected non-union, congenital pseudarthrosis, osteomyelitis and bone tumours [70][71][72][73].…”

Section: Alternatives To Operative Lengtheningmentioning

confidence: 99%

Current concepts of leg lengthening

Hasler

Krieg

2012

Journal of Children's Orthopaedics

101

View full text Add to dashboard Cite

Any lower limb discrepancy may be equalised by conservative means (insoles, prosthesis and orthosis). However, their long-term acceptance is low in regard to function, costs, expenditure and appearance. Timely epiphysiodesis is the best option in uniplanar deformities with adequate remaining growth and for patients whose predicted final body height is above the 50th percentile. However, many patients present late or with multi-planar deformities, which warrant more sophisticated operative approaches. The history of surgical bone lengthening comprises 100 exciting years of struggling, development and ongoing learning. The initial strategy of acute or rapid incremental distraction had lasted almost half a century until Ilizarov recognised the benefits of biological periosteum-preserving osteotomies and incremental lengthening at slow rates (1 mm/day) at a 4 × 0.25-mm daily rhythm, well appreciated as callotasis. In parallel, ring and wire constructs made complex three-dimensional axial, translational and rotational bone moulding possible. Taylor Spatial Frames—built on hexapod strut-linked platform technology as known from flight simulators—took limb correction to a more reliable, more precise and aesthetical level, all the more that the whole process became web-based. It represents state-of-the-art methodology and technology for complex, multi-plane deformities. Due to the significant risk of secondary malalignment, indications for lengthening by unilateral fixation have shrunken to moderate amounts of length disparity and uni- to bi-planar deformities in patients with still open physes. Mechanical or motorised, minimally invasively placed nails prevent muscle fixation and, therefore, ease rehabilitation, increase patient comfort and potentially shorten the overall time of sick leave and refrain from sports activities. Hence, they offer a valuable alternative for low-grade complexity situations. It remains to be proved if the significantly higher implant costs are compensated by lower treatment costs. Overall, limb lengthening, particularly in combination with multi-planar deformity correction, can still be an arduous endeavour. In any case, wise judgement of the patient’s deformity, medical and biological situation, psychosocial environment, selection of the appropriate method and hardware, as well as meticulous operating technique by an experienced surgeon are the cornerstones of successful outcomes.

show abstract

“…The living bone regenerated in distraction osteogenesis will eventually provide sufficient biomechanical strength, length and durability [24,26,30,31]. Merle d'Aubigne was the first to use an intramedullary nail in the resection arthrodesis of the knee [29].…”

Section: Discussionmentioning

confidence: 99%

A novel approach to juxta-articular aggressive and recurrent giant cell tumours: resection arthrodesis using bone transport over an intramedullary nail

Vidyadhara

Rao

2006

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

A novel approach to juxta-articular aggressive and recurrent giant cell tumours: resection arthrodesis using bone transport over an intramedullary nail Abstract Aggressive juxta-articular giant cell tumours of the lower limbs occurring in young patients are a challenge to the average orthopaedic surgeon. Although it is the treatment of choice for these tumours, wide resection creates a problem for the reconstruction of large bone gaps. We describe our results after resection arthrodesis of such tumours using the technique of bone transport over a long intramedullary nail in 27 patients. This is the first and largest study of its kind in the management of giant cell tumours in the literature. All our patients fared well with this mode of treatment, and none had recurrence or major complications.

show abstract

Resection-shortening-distraction for malignant bone tumours. A report of two cases

Abstract: We report two patients with malignant bone tumours treated by wide marginal resection in whom the residual bone defect was replaced by progressive distraction after allowing union to commence in the shortened position.

Cited by 22 publications

References 5 publications

The Ilizarov Method in the Management of Giant-Cell Tumours of the Proximal Tibia

The Ilizarov Method in the Management of Giant-Cell Tumours of the Proximal Tibia

Current concepts of leg lengthening

A novel approach to juxta-articular aggressive and recurrent giant cell tumours: resection arthrodesis using bone transport over an intramedullary nail

Contact Info

Product

Resources

About