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• W4386296006 abstract "Improvements in imaging methods and adjuvant chemotherapy have increased survival rates in children with bone sarcomas up to 80%, therefore long-lasting limb salvage procedures are needed. To describe a case series of pediatric patients who have undergone physeal distraction prior to tumor resection for treatment of metaphyseal malignant bone tumors. Between January 2007 to December 2020, 8 patients (5 boys and 3 girls) with a mean age of 7.2 years (2–13), underwent physeal distraction as the first stage of a tumor resection protocol. Six patients had Ewing's sarcoma and two had osteosarcoma. Tumor locations were: proximal tibia (4 cases), distal femur, proximal humerus, distal radius, and distal fibula (1 case each). The affected bones were replaced with cadaver allograft in 6 patients; there was also one fibula autograft and one vascularized fibula graft. Chemotherapy was administered pre- and post-surgery; one patient received adjuvant radiotherapy. Average follow-up was 62.6 months (8–152). Physeal distraction lasted an average of 10.6 days (3–15); delay to definitive resection was 17 days (range 13–22). Mean length of resection was 10.7 cm (range 5–14) and all had negative margins. There were no local recurrences. Three patients suffered disease progression with metastasis and died. Surgical complications included: pin infection (1 patient), surgical site infection (2 patients), allograft fracture (1 patient), and nonunion of the diaphyseal junction (3 patients). Final lower limb length discrepancy was 1.5 cm (range 1–2 cm). Normal joint function was achieved in 6 patients. The mean MSTS score was 75% (53%–97%). Physeal distraction technique is an oncologically safe limb salvage procedure with good functional results, and it should be considered in the treatment of metaphyseal pediatric malignant tumors." @default.
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• W4386296006 date "2023-12-01" @default.
• W4386296006 modified "2023-10-17" @default.
• W4386296006 title "Physeal distraction prior to excision of metaphyseal malignant bone tumors in children: Preserving joint function and limb growth" @default.
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• W4386296006 doi "https://doi.org/10.1016/j.cson.2023.100021" @default.
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