Abstract
In an 11-year-old boy with osteosarcoma in the proximal tibia (type iii), 2 cycles of dia chemotherapy (cisplatin, ifosfamide, doxorubicin) were administered preoperatively while epiphysiolysis was performed. Clinical response was determined to be complete by radiography and histopathology. Marginal excision was then performed with preservation of the proximal tibial epiphysis. Metaphyseal reconstruction was performed using distraction osteogenesis. Six cycles of dia chemotherapy were administered postoperatively. Twenty months later, the patient had developed no complications and experienced full bone healing, with no limb discrepancy. In selected adolescent patients with osteosarcoma, in whom the tumour is in full contact with the epiphysis, epiphyseal preservation by epiphysiolysis and reconstruction by distraction osteogenesis can provide an excellent outcome, resulting in a stable reconstruction that functionally restores the native limb.
Highlights
In malignant bone tumours affecting children and adolescents, 75% are located close to the growth plate[1]
If all the tumour is in full contact with the epiphysis, physeal distraction is contraindicated[3]
We describe a case of osteosarcoma in the proximal tibia that was successfully managed with epiphysiolysis and distraction osteogenesis
Summary
In malignant bone tumours affecting children and adolescents, 75% are located close to the growth plate[1]. Treatment of juxtaarticular osteosarcomas near the knee with epiphysis preservation and biologic reconstruction using distraction osteogenesis can yield excellent functional results[2]. If all the tumour is in full contact with the epiphysis (type iii3), physeal distraction is contraindicated[3]. We describe a case of osteosarcoma in the proximal tibia (type iii) that was successfully managed with epiphysiolysis and distraction osteogenesis.
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