Total Resection of Long Bone in Malignant Tumors

Abstract

The experience of total resection of long bones in 32 patients with malignant and metastatic tumors is presented. When tumor was located in the femur the bone defect was filled in by Sivash’s implant complex; when the tumor was located in the shoulder - individual custom polymeric implants were applied. After clavicular extirpation no defect was filled in, however it did not affect functional disability of the hand and when the patient was dressed the cosmetic defect was not seen. In vast damage of the humerus diaphysis and intact epiphyses the authors recommend to perform diaphysis resection followed by the application of autograft from fibula on microvascular anasthomosis. After those operation the hand function was completely preserved. In patients with metastatic damage total resection of long bone was carried out in case of solitary metastase as well as in multiple metastases with pathologic fractures or with the risk of pathologic fractures. The indications for total resection of the femur in metastatic tumors should be strictly limited because of severity of the operation. Total resection of long bone with correct planning and careful operative technique versus amputation and exarticulation gives the same oncologic outcome and herewith provides significantly higher of patient’s life.

Keywords

total bone removal / autograft / endoprosthesis / osteoblastoclastoma / chondrosarcoma

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