KMID : 0361620180530030264
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Journal of the Korean Orthopaedic Association 2018 Volume.53 No. 3 p.264 ~ p.270
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Complications of Allograft Reconstruction following Wide Resection of Malignant Bone Tumors in Long Bones
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Kim Kap-Jung
Lee Sang-Ki Jeon Chung-Youb Ma Chang-Hyun Kim Su-Min
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Abstract
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Purpose: We evaluated the results of allograft reconstruction following wide resection of malignant bone tumors in long bone, retrospectively.
Materials and Methods: Seven patients were included. The mean age was 44 years old. Male was 4 cases, and female was 3 cases. Mean follow-up period was 38 months. The mean Musculoskeletal Tumor Society (MSTS) score at final follow-up was evaluated. Postoperative complications were evaluated via periodic radiologic follow-up. Oncologic results were analyzed at final follow-up.
Results: The primary malignancies occurred at femur in 5 cases, humerus in 1 case and tibia in 1 case. Pathologic diagnoses were osteosarcoma in 4 cases, multiple myeloma in 2 cases and adamantinoma in 1 case. Mean length of allograft was 165 mm. Fixations of allograft were intramedullary nailing with additional plate in 4 cases, intramedullary nailing in 2 cases, and screw fixation in 1 case. Mean time to union was 14.5 weeks. Mean MSTS score at final follow-up was 20 (67%). Postoperative complications were nonunion in 3 cases, implant failure in 1 case, and infection in 1 case. Oncologic outcomes were continuous disease free in 5 cases and alive with disease in 2 cases at final follow-up. Autologous bone graft and hemi-cortical onlay graft were performed in 2 cases of nonunion.
Conclusion: Allograft reconstruction following wide resection of malignant bone tumors in long bone was effective surgical option. However, the possibility of nonunion between host bone and allograft should be considered.
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KEYWORD
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malignant bone tumor, wide resection, allografts
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