Limb-sparing of the lower extremity by using the expandable prosthesis in children with malignant bone tumor

Abstract

Improved diagnostic modalities and progress in chemotherapy protocols has resulted in the increased survival of cancer patients. This has stimulated the search for ways to improve their quality of life. Better understanding of the biological behavior of tumor progress and spread resulted in new and safer surgical approaches that minimized local recurrence. Limb-sparing in children has proven to be successful and does not compromise the survival rate when compared with cross-bone amputation. With the introduction of the expandable prosthesis, the problem of limb length discrepancy has been solved. As the child grows, serial lengthening is performed. The number of lengthenings is dependent on the child's age at the time of presentation and the individual rate of growth. Limb-sparing in children is associated with a high morbidity rate related to multiple surgical procedures; however, the majority of surviving patients believe that the surgical effort to save the limb and the eventual functional outcome were worthwhile. The long-term experience with the use of the expandable prosthesis in sixty patients is presented.