Excision of Proximal Fibular Tumors: A New Posterior Surgical Approach

Lindeque, Bennie; Oren, Trevor W.

doi:10.3928/01477447-20100225-14

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…1 The incidence of primary bone tumors in the fibula is between 2.5% and 4.08% of all primary bone tumors. 2 –4 The close proximity to the surrounding tissues including the anterior tibial artery, the common peroneal nerve, and the lateral collateral ligament (LCL) causes major difficulties in proximal fibula tumor resections to provide clean histological margins. 5 Malawer described two types of en bloc resection: Type I, marginal resection, includes resection of proximal fibula with 2–3 cm of diaphysis and muscles around fibula (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Clinical and radiologic outcomes following resection of primary proximal fibula tumors: Proximal fibula resection outcomes

Arıkan

Mısır

Gur

et al. 2019

J Orthop Surg (Hong Kong)

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Reconstruction of the lateral collateral ligament (LCL) and biceps femoris tendon following proximal fibula resection is controversial. Postoperative knee instability and peroneal nerve dysfunction affect outcome. This study aimed to determine functional, clinical, and radiological outcomes of patients who underwent en bloc proximal fibula resections and to compare clinical and radiological instability rates for primary repair after type I and type II resections. Materials and Methods: Eleven patients with primary tumors of the proximal fibula were included. Musculoskeletal Tumor Society (MSTS) score and Lysholm knee score were used in the evaluation of functional outcomes. Clinical outcome was assessed using knee range of motion and knee varus stress test. Radiological outcome was assessed using varus stress knee radiographs. Knee stability was evaluated using the varus stress test at 30 of knee flexion and varus stress knee radiographs and graded in millimeters. Results: Of the 11 tumors, 6 (54.6%) underwent type I resection. In five (45.4%) patients, type II resection was performed. The mean follow-up period was 32 + 13.9 months (range, 12-55 months; median, 27 months). The mean knee joint lateral opening, MSTS score, and Lysholm knee score with type I versus type II resection were 5.7 + 1.2 mm versus 6.4 + 1.1 mm (p ¼ 0.247), 28.7 + 1.8 (95.6%) versus 20.4 + 7.7 (68%) (p ¼ 0.011), and 92.2 + 8.8 versus 62.8 + 20.4 (p ¼ 0.026), respectively. Postoperative complications of all patients included one (9.1%) deep tissue infection and one (9.1%) long-term knee instability. In one patient (9.1%) who underwent type II resection, above-the-knee amputation was performed after local recurrence. Conclusions: Primary repair of the LCL and biceps femoris tendon to the surrounding soft tissues after resection of proximal fibular tumors provides good clinical outcomes. Primary repair is a simple technique to perform with minimal morbidity. Peroneal nerve palsy was a problem, especially in type II resections.

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Section: Introductionmentioning

confidence: 99%

Clinical and radiologic outcomes following resection of primary proximal fibula tumors: Proximal fibula resection outcomes

Arıkan

Mısır

Gur

et al. 2019

J Orthop Surg (Hong Kong)

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Modified resection technique for proximal fibular osteochondromas

Mootha

Saini

Dhillon

et al. 2011

Orthopaedics & Traumatology: Surgery & Research

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Osteochondroma is one of the most common tumors arising from the proximal fibula. Surgical treatment of proximal fibula osteochondromas may vary from debulking to resection of proximal fibula. We describe a modified surgical technique for excision of proximal fibular osteochondromas which preserves the proximal tibio-fibular joint (PTFJ). We present a series of six cases of symptomatic proximal fibular osteochondroma. Four cases were solitary osteochondromas while two were a manifestation of a hereditary multiple exostoses. Indication for surgery was peroneal nerve symptoms in three, cosmesis in one, restricted knee motion in one, and pain in one case. All these cases were operated by a modified resection technique where the head of fibula was preserved. The PTFJ was preserved. Lateral stabilizing structures of the knee were left undisturbed, and hence did not need repair. Complications occurred in two patients, one had marginal wound necrosis and one had persistent weakness of extensor haullicis longus. At a minimum follow-up of 2 years, none had recurrence or late disruption of PTFJ.

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Excision of Proximal Fibular Tumors: A New Posterior Surgical Approach

Cited by 2 publications

References 5 publications

Clinical and radiologic outcomes following resection of primary proximal fibula tumors: Proximal fibula resection outcomes

Clinical and radiologic outcomes following resection of primary proximal fibula tumors: Proximal fibula resection outcomes

Modified resection technique for proximal fibular osteochondromas

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