Effect of pathological fracture on limb salvage surgery with preservation of the epiphysis in children with osteosarcoma of the distal femur: Two case reports

  • Authors:
    • Kai Zheng
    • Xiuchun Yu
    • Zhengqi Chang
    • Songfeng Xu
    • Ming Xu
  • View Affiliations

  • Published online on: February 11, 2016     https://doi.org/10.3892/mco.2016.777
  • Pages: 523-526
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Abstract

The outcome of limb salvage treatment for femoral osteosarcoma with pathological fractures in children is currently unknown. The aim of the present study was to present two cases of patients who received limb salvage surgery with preservation of the epiphysis at the Department of Orthopedics of The General Hospital of Jinan Military Commanding Region (Shandong, China). Between January, 2007 and January, 2013, two pediatric patients were admitted to our hospital with pathological fractures. one of the patients was a girl, aged 11 years, with confirmed osteosarcoma of the right distal femur; the other patient was a boy, aged 9 years, with osteosarcoma of the left distal femur. After receiving two cycles of neoadjuvant chemotherapy following tumor biopsy, the patients received limb salvage surgery with epiphyseal preservation, with wide resection of the tumor and biological reconstruction by allogeneic bone and fibular autograft, followed by 10 cycles of adjuvant chemotherapy. With a mean follow‑up of 64 months, there were no postoperative complications, local recurrence or metastasis. The limb function recovered well, although limb shortening was observed. The female patient underwent a second fixation and limb lengthening after epiphyseal closure. Therefore, with effective neoadjuvant chemotherapy, limb salvage surgery with epiphyseal preservation is not contraindicated for pediatric patients with pathological fractures from femoral osteosarcoma. Biological reconstruction by allogeneic bone and vascularized fibular autograft following wide tumor resection is a viable option for such patients, with a good postoperative functional outcome.
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April 2016
Volume 4 Issue 4

Print ISSN: 2049-9450
Online ISSN:2049-9469

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APA
Zheng, K., Yu, X., Chang, Z., Xu, S., & Xu, M. (2016). Effect of pathological fracture on limb salvage surgery with preservation of the epiphysis in children with osteosarcoma of the distal femur: Two case reports. Molecular and Clinical Oncology, 4, 523-526. https://doi.org/10.3892/mco.2016.777
MLA
Zheng, K., Yu, X., Chang, Z., Xu, S., Xu, M."Effect of pathological fracture on limb salvage surgery with preservation of the epiphysis in children with osteosarcoma of the distal femur: Two case reports". Molecular and Clinical Oncology 4.4 (2016): 523-526.
Chicago
Zheng, K., Yu, X., Chang, Z., Xu, S., Xu, M."Effect of pathological fracture on limb salvage surgery with preservation of the epiphysis in children with osteosarcoma of the distal femur: Two case reports". Molecular and Clinical Oncology 4, no. 4 (2016): 523-526. https://doi.org/10.3892/mco.2016.777