Reconstruction of defects following bone tumor resections by distraction osteogenesis

Erler, Kaan; Yıldız, Cemil; Baykal, Barbaros; Ateşalp, A. Sabri; Özdemir, Mahmut; Basbozkurt, Mustafa

doi:10.1007/s00402-005-0795-5

Cited by 32 publications

(25 citation statements)

References 24 publications

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“…According to Kempson, removal of the periosteum around the lesion is important to prevent recurrence, and therefore, subperiosteal curettage or subperiosteal excision is not appropriate 21. Some authors claim that early surgical intervention should be more radical than the previously recommended interventions 22,23…”

Section: Discussionmentioning

confidence: 99%

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Treatment of Osteofibrous Dysplasia and Associated Lesions

et al. 2007

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PurposeTo report long term treatment outcomes of osteofibrous dysplasia and association with adamantinoma.Patients and MethodsFrom January 1984 to July 2001, 14 patients with osteofibrous dysplasia were followed for an average of 108 months (78 to 260 months). Our patient group consisted of 6 men and 8 women, with a mean age of 13.9 years (2 to 65 years). We reviewed the clinical and pathological features of all 14 patients.ResultsThirteen patients had a lesion in the tibia, while one patient had lesions in both the tibia and the fibula. Initial treatments were observation after biopsy (6 patients), curettage with or without a bone graft (3 patients), resection followed by a free vascularized fibular bone graft (4 patients), or resection and regeneration with the Ilizarov external fixation (1 patient). Curettage was performed on 6 patients due to recurrence or progression after the initial treatment. Among these patients, one was diagnosed with AD from the biopsy of the recurrent lesion. This patient was further treated by segmental resection and pasteurization. After the initial pathology slides of the 13 patients were reviewed with immunohistochemical cytokeratin staining, one patient diagnosis was changed from osteofibrous dysplasia to osteofibrous dysplasia-like adamantinoma.ConclusionSome patients with osteofibrous dysplasia require close observation because of the high association risk between osteofibrous dysplasia and adamantinoma, Immunohistochemical staining may be helpful in differentiating these two diagnoses.

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Section: Discussionmentioning

confidence: 99%

“…However, in the cases of rapid disease progression with involvement of the entire tibia or in cases of recurrent pathological fractures, a wide resection followed by reconstruction is necessary. And the severe bowing deformity also requires an early correctional operation 1,3,4,9,17,18,22,23…”

Section: Discussionmentioning

confidence: 99%

Treatment of Osteofibrous Dysplasia and Associated Lesions

et al. 2007

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“…Most data are from the European experience with few patients in each series. [45][46][47][48][49][50]53 Up to 10 cm mean length has been gained by this method at a slow rate of one centimeter per month. The major risk of this externally applied apparatus of trans-osseous pins and metal frames is infection of the pins protruding through the skin.…”

Section: Other Considerationsmentioning

confidence: 99%

Surgical Management of Primary Osteosarcoma

Yasko

2009

Cancer Treatment and Research

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Surgical strategies for the primary tumor for patients with extremity and pelvis osteosarcoma have evolved from the ablative to limb-sparing approaches over the past three decades. Favorable oncologic and functional outcomes with contemporary tissue-conserving techniques consistently observed in skeletally mature patients have prompted the application of similar approaches to a growing number of eligible skeletally immature patients. In response to emerging long-term outcome data, current strategies have focused principally on refining the nature and scope of surgical resection to preserve uninvolved tissues, and on the adoption of novel biological and nonbiological skeletal and soft-tissue reconstruction methods to optimize function. We focus on these clinical issues and discuss current efforts to advance the surgical management of the primary tumor and address the limitations of the definitive treatment of the primary tumor, including locally recurrent disease and complications of skeletal reconstructions.

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“…In addition, external fixation is sometimes used after primary oncological surgery, for the treatment of asymmetry (bone lengthening), pseudoarthrosis, infection, correction of angular deformity, and rescue surgery for knee prosthesis that has succumbed to bone reabsorption (9). For distraction oeteogenesis, the Ilizalov method of external fixation is frequently used in the management of bone tumors (10,11).…”

Section: Discussionmentioning

confidence: 99%

Operative Treatment by External Fixation for Polyostotic Fibrous Dysplasia in The Elbow Joint.

Matsuya

Hatori

Hosaka

et al. 2006

Upsala Journal of Medical Sciences

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Fibrous dysplasia is a condition in which normal skeletal bone changes into fibroblastic stroma and immature bone. We report our experience of a unilateral external fixator applied for the treatment of polyostotic fibrous dysplasia arising in the elbow. The patient was a 38 year-old man. His main complaint was left elbow pain and a mass, which increased in size. The histological diagnosis from the needle biopsy was fibrous dysplasia. An articulated unilateral external fixator was used for immobilization. The lesions in the left distal humerus and proximal ulna were curetted and cancellous bone was packed into the cavity. An external fixator (Elbow Fixator, Orthofix Inc., McKinney, USA) was applied from the proximal humeral shaft to the distal ulnar shaft for postoperative tentative immobilization and preservation of the affected elbow joint movement.At two years after the operation, the range of motion of the affected elbow was 90 degrees in flexion and -35 degrees in extension. The range of motion in pronation and supination of the left forearm was normal. No evidence of recurrence was noted at two years after surgery. The merits of using an external fixator were: an earlier start of range of motion exercises, and a decrease in the risk of tumor dissemination.

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Reconstruction of defects following bone tumor resections by distraction osteogenesis

Abstract: Our results indicate that the Ilizarov method allows effective restoration of bone defects in the treatment of bone tumors despite various disadvantages.

Cited by 32 publications

References 24 publications

Treatment of Osteofibrous Dysplasia and Associated Lesions

Treatment of Osteofibrous Dysplasia and Associated Lesions

Surgical Management of Primary Osteosarcoma

Operative Treatment by External Fixation for Polyostotic Fibrous Dysplasia in The Elbow Joint.

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