悪性骨腫ようの患肢温存例における機能的予後と合併症

Abstract

We studied the function and complications of the affected limbs after limb salvage procedures in 31 patients with malignant bone tumors. Limb salvage procedures consisted of high-dose fractionated external radiotherapy, wide resection with or without reconstruction for osteoarticular defects by bone graft and prosthetic replacement, and intraoperative radiotherapy.Function was evaluated according to Enneking's criteria. Excellent results were achieved in 6 patients and good results in 15.Fair and poor results were seen in the 2 patients who underwent extensive muscle resection at surgery, and also in the other 8 patients with postoperative complications, such as non-union and fracture of grafted bone, loosening of prosthetic replacement, and deep infection. Moreover, high-dose fractionated external radiotherapy frequently gave rise to severe radiation side effects in the soft tissue.Because the limb salvage procedure using intraoperative radiotherapy preserved the stability of nearby joints and considerably reduced radiation side effects, it appears to offer the best treatment in terms of the postoperative function of the affected limbs.