Our Experience with the Modular Universal Tumour and Revision System in Pediatric Patients with Ewing's Sarcoma – Report of Six Cases

Abstract

Ewing’s sarcoma (ES) usually affects patients between 10 and 19 years of age and has a rapid progression. The main goal of surgical treatment is to remove the tumour with at least wide margins, limb salvage being achievable in most cases. In recent years, modular tumour endoprostheses have become one of the main methods used in children. From August 2012 to May 2019, six patients with histologically diagnosed ES underwent limb salvage surgery and reconstruction with a MUTARS® type endoprosthesis. The mean age of the patients is 12.6 years (from 8 to 16). For the reconstruction in all six patients we used MUTARS® type endoprostheses, two of which were expandable (MUTARS® Xpand) (33.33%). The average follow-up period was 40 months. The longest follow-up was 96 months. The average MSTS score one month after operative treatment and rehabilitation was 62% (18/30) and the average MSTS score after 12 months was 72% (21/30). Mechanical failure of the expanding mechanism was the main complication we encountered in our series. In conclusion limb salvage surgeries and reconstruction with modular tumour endoprostheses give patients with Ewing’s sarcoma not only a chance for a disease-free life, but a potentially functional limb.