Pelvic reconstruction with different rod-screw systems following Enneking type I/I + IV resection: a clinical study.

Peng Lin,Hengyuan Li,Zhaoming Ye,Zhengliang Zhang,Shengdong Wang,Huigen Lu,Zhan Wang,Nong Lin,Haiqing Lin,Youyou Shao,Binghao Li

doi:10.18632/oncotarget.17164

Abstract

The mechanical outcomes of patients with pelvic bone tumors involving zone I or zone I + IV who received resection and different reconstructions are not clear. Therefore, the purpose of this study was to compare the outcomes of different rod-screw systems in reconstruction for these patients, and evaluate the relative risk of mechanical failure for them. We reviewed 30 patients for a mean duration of 40.4 months of follow-up (range, 13.1–162.2 months), five patients had mechanical complications. The mechanical survival rate of two-rod and four-screw (TRFS) group was significantly higher than one-rod and two-screw (ORTS) group (p = 0.000). The implant survival rate was correlated with ages (p = 0.010), younger people are more likely to fail. Thus, TRFS fixation for pelvic reconstruction after Enneking type I/I + IV resection can provide better short to long-term mechanical stability compared with ORTS fixation, the strength of ORTS fixation is not enough. In addition, biological reconstruction such as autologous bone graft is recommended for the patients who are younger or suffered from benign tumor. As for the patients who are older, with malignant tumors, underwent adjuvant radiotherapy or chemotherapy, functional reconstruction with bone cement is a good choice.

Highlights

Reconstruction after resection of pelvic bone tumors involving zone I or zone I + IV remains one of the most demanding procedures
The mechanical survival rate of two-rod and four-screw (TRFS) group was significantly higher than one-rod and two-screw (ORTS) group (p = 0.000)
TRFS fixation for pelvic reconstruction after Enneking type I/I + IV resection can provide better short to long-term mechanical stability compared with ORTS fixation, the strength of ORTS fixation is not enough

Summary

Introduction

Reconstruction after resection of pelvic bone tumors involving zone I or zone I + IV remains one of the most demanding procedures. Limb-salvage surgeries for pelvic tumors were challenging procedures [4], but a great deal of clinical experience, along with the developments of imaging, adjuvant therapies, surgical techniques and reconstruction materials, have proved such kind of surgeries is feasible for selected patients [5,6,7,8]. The challenge in reconstruction is to providing a solid reconstitute of pelvic girdle and reduce collapse or rotation of the residual portion of the hemipelvis after weight-bearing and remain good function in short term and in long term follow up. Among multifarious reconstruction methods after internal hemipelvectomy (type I or type I + IV), stable internal fixation and pelvic girdle reconstruction allowed early ambulation and provide better short-term www.impactjournals.com/oncotarget to long-term outcomes and function, the postoperative complications are common [4,5,6,7, 20]

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