Treatment of benign bone tumours using external fixation

Abstract

We present a retrospective study of patients suffering from a variety of benign tumours in whom external fixators were used to treat deformity and limb-length discrepancy, and for the reconstruction of bone defects. A total of 43 limbs in 31 patients (12 male and 19 female) with a mean age of 14 years (2 to 54) were treated. The diagnosis was Ollier's disease in 12 limbs, fibrous dysplasia in 11, osteochondroma in eight, giant cell tumour in five, osteofibrous dysplasia in five and non-ossifying fibroma in two. The lesions were treated in the tibia in 19 limbs, in the femur in 16, and in the forearm in eight. The Ilizarov frame was used in 25 limbs, the Taylor Spatial Frame in seven, the Orthofix fixator in six, the Monotube in four and the Heidelberg fixator in one. The mean follow-up was 72 months (22 to 221). The mean external fixation period was 168 days (71 to 352). The mean external fixation index was 42 days/cm (22.2 to 102.0) in the 22 patients who required limb lengthening. The mean correction angle for those with angular deformity was 23 degrees (7 degrees to 45 degrees ). At final follow-up all patients had returned to normal activities. Four patients required a second operation for recurrent deformity of further limb lengthening. Local recurrence occurred in one patient, requiring further surgery.

Repair of Tibial Nonunions and Bone Defects with the Taylor Spatial Frame

“…The outcomes were similar to other series reported in the literature. [8][9][10]13,15,[20][21][22][23][24][25][26]41 This is the largest series in the English language orthopaedic literature of tibial nonunions treated with the TSF. Feldman et al 10 reported their experience with the TSF for 18 nonunions and malunions.…”

“…Once contact and compression at the nonunion site were achieved, additional stabilization of the TSF was accomplished by adding rods or additional struts to lock the frame. Precise deformity correction [41][42][43][44][45] and ease of use 43,44,46 have been cited by other authors as advantages of the TSF. Kristiansen et al 46 showed that the external fixation index was comparable between the TSF and the classic Ilizarov frame.…”

Non-ossifying fibroma, fibrous cortical defect and Jaffe–Campanacci syndrome: a biologic and clinical review

“…The fractures usually spontaneously heal and it seems logical to allow that to happen before trying to insert external fixators, internal metallic devices, autograft bone, or allograft chips with or without cement unless the lesions are in a site at risk for deformity [1,15,23,39,60]. The principal site where the limb may be at risk is the proximal femur.…”

Over 10-year follow-up of functional outcome in patients with bone tumors reconstructed using distraction osteogenesis

“…We have been using distraction osteogenesis, a biological approach for repairing segmental bone defects, since 1990. Distraction osteogenesis can regenerate bone of sufficient strength and can preserve limb function [11][12][13][14][15][16][17][18]. Little has been reported about the long-term functional outcomes of patients who undergo distraction osteogenesis to reconstruct bone defects caused by excision of bone tumors.…”