مرکز منطقه ای اطلاع رساني علوم و فناوري - Applications of external fixation for management of complications associated with musculoskeletal tumors and related surgery

Latin Abstract :

Objectives: We evaluated the results of, and the course of treatment with, external fixation (EF) in treating complica¬tions associated with bone tumors and related surgery. Methods: Eighteen patients (9 males, 9 females; mean age 19 years; range 6 to 35 years) who were treated with EF were evalu¬ated in three groups. Histologic diagnoses were osteosarcoma (n=3), Ewingʹs sarcoma (n=3), hereditary multiple exostosis (n=3), chondrosarcoma (n=2), synovial sarcoma (n=2), Ollierʹs disease, giant cell tumor of bone, desmoid fibroma, chondro- myxoid fibroma, and enchondroma. Complications secondary to bone tumors (n=4) and occurring following limb salvage sur¬gery (n=14) were treated with Ilizarov circular EF in nine pa¬tients, unilateral EF in six patients, and both in three patients. Results: The first group included eight patients who were treat¬ed with EF for infection and nonunion or deformity following surgery. The mean shortening was 10.6 cm, the mean lengthen¬ing was 9.7 cm, and the mean external fixator index was 48.8 days/cm. One patient developed fracture of the free vascular- ized fibula graft after EF removal, and amputation was required in two patients. The second group consisted of six patients who had shortening secondary to tumor surgery. The mean shorten¬ing was 7.5 cm, the mean lengthening was 6.5 cm, and the mean external fixator index was 28 days/cm. In this group, the ma¬jor complications were implant failure and knee stiffness. The third group included four patients with deformity and shorten¬ing secondary to multiple exostosis (n=3) and Ollierʹs disease. The mean shortening was 7.5 cm, the mean lengthening was 6.5 cm, and the mean external fixator index was 57.2 days/cm. One patient developed ulnar shortening of 2 cm after growth. Conclusion: The use of EF in the management of complica¬tions associated with bone tumors and related surgery yields successful results especially in young patients.