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KMID : 0613319960020020218
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Journal of the Korean Bone and Joint Tumor Soceity
1996 Volume.2 No. 2 p.218 ~ p.223
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Arthrodesis of Knee Joint with Intramedullary Nailing and Bone Cement after Removal of Infected Tumor Prosthesis from the Proximal Tibia
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Park Il-Hyung
Lee Jong-Min
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Abstract
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An eighteen-year-old boy was treated with the cemented-type custom made tumor prosthesis (Link Endo model) after wide resection of the proximal tibial osteosarcoma. 27cm of the right proximal tibia and 16cm of the fibula were resected. Because there was an extensive loss of soft tissue of entire lower leg for surgical margin, transpostion of the gastronemius to cover the prosthesis could not be done and the prosthesis was covered only with skin flap, which was approximated easily without skin graft. However, deep infection developed shortly after operation and anterior half of the entire posthesis was exposed through the retracted skin flap. Whole prosthesis was removed and thorough debridement of the infected marrow and granulation tissue was done. Antibiotics-impregnated cement beads with mono-external fixator was applied. After infection was controlled completely, a long intramedullary nail(Huckstep) with interlocking screws was inserted from middle of the femur to the body of the calcaneous through the ankle joint. Palacos bone cements were used to wrap the nail as a apacer. Skin was able to be approximated primarily although the leg was 2cm shorter than the normal side. Patient is contknuous disease free state for 43 months and is very satisfied with the result and
has been keeping normal daily activities with mild intermittent ankle pain.
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KEYWORD
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Infected Tumor Prosthesis, IM nail, Knee arthrodesis
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