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KMID : 0613319980040030127
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Journal of the Korean Bone and Joint Tumor Soceity
1998 Volume.4 No. 3 p.127 ~ p.135
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Staged Lower Limb Salvage in Pediatric Osteosarcoma
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Jeon Dae-Geun
Lee Jong-Seok
Kim Sug-Jun
Lee Soo-Yong
Cho Wan-Hyeong
Kwag Bong-Jun
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Abstract
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Limb salvage in pediatric primary sarcoma of the bone has the problem of expected leg-length discrepancy quite apart from any tumor-related factors. Our concept is a stepwise approach for each problem. From May 1991 to Apr. 1994, 16 pediatric ⅡB osteosarcoma cases were analyzed. Stage-1 was temporary arthrodesis after tumor resection. Stage-2 was limb-lengthening with Iizarov device and stage-3 was rearthrodesis or conversion to a mobile joint following the situation of the patient. Average age of stage-3 fusiolarthroplasty cases at diagnosis was 9.5/11.3 years. Nine cases were switched to a mobile joint and 6 had rearthrodesis due to skeletal immaturity while 1 remaining patient had allograft-hemi arthroplasty composite. Average fusion period for 9 arthroplasty cases was 44(range:33-58) months and this played no major part in the final functional score(26). The major factors for this procedure were skeletal maturity at diagnosis, extent of initial bone resection and quality of remaining bone. Patients 10 years of age and under at diagnosis have difficulty in accomplishing the final goal of mobile equivalent limb, but those aged 11 and over can have a better chance even though late mechanical problems are anticipated.
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KEYWORD
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Osteosarcoma, Limb salvage, Pediatric
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