Plastic lengthening amputation with vascularized bone grafts in children with bone sarcoma: a preliminary report
- PDF / 4,917,234 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 20 Downloads / 192 Views
(2020) 18:246
RESEARCH
Open Access
Plastic lengthening amputation with vascularized bone grafts in children with bone sarcoma: a preliminary report Zhiqiang Zhao1,2†, Qinglin Jin1,2†, Xianbiao Xie1,2, Yongqian Wang1,2, Tiao Lin1,2, Junqiang Yin1,2, Gang Huang1,2, Changye Zou1,2* and Jingnan Shen1,2*
Abstract Background: At present, amputation was widely adopted for young patients when limb salvage was deemed risky with several surgical strategy such as rotationplasty. However, leg length discrepancies and unfavorable cosmetic results were indispensable complication of this strategy. The purpose of this study was to propose a novel reconstruction strategy and evaluate the early clinical and functional outcomes of the strategy. Methods: Plastic lengthening amputation (PLA) has been developed by lengthening the stump to preserve one additional distal joint for fixing the artificial limb well. The surgical technique and postoperative management were documented, and the functional outcomes were compared with those of traditional amputation (TA). Six pairs of patients matched for age, sex, location, pathological type, and final prosthesis underwent individually designed plastic lengthening amputation with vascularized autografts or traditional amputation between January 2005 and December 2007. All patients were followed, and the locomotor index and the musculoskeletal tumor society score (MSTS) were used to describe and quantitatively grade limb functional outcomes after amputation. The complications and functional outcomes of the patients taken two kinds of procedures were compared. Results: Twelve patients with osteosarcoma or Ewing’s sarcoma of either the femur or tibia were included in the study. Six patients underwent plastic lengthening amputations, three of whom also underwent vascular anastomosis. Patients were followed for an average of 48.17 months; bone healing required an average of 3.3 months. No local recurrence was found. The average postoperative locomotor index functional score of the affected limb was 32.67 ± 5.89 in the plastic lengthening amputation group while was 19.50 ± 7.87 in the traditional amputation group. The MSTS functional scores were 22.67 ± 1.33 and 24.17 ± 1.45 at 6 and 12 months for patients in PLA group while 17.00 ± 1.549 and 17.83 ± 1.64 at 6 and 12 months for patients in TA group. Conclusions: Plastic lengthening amputations with vascularized autografts could preserve the knee joint to improve the function of the amputated limb in selected bone sarcoma patients. Keywords: Sarcoma, Limb, Amputation, Resection, Reconstruction
* Correspondence: [email protected]; [email protected] † Zhiqiang Zhao and Qinglin Jin contributed equally to this work. 1 Department of Musculoskeletal Oncology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use,
Data Loading...
