The Borggreve rotation-plasty. A surgical method in therapy of malignant bone tumors and functional results

Abstract

From 1980 to 1992, 39 Borggreve-rotation-plasties were performed in patients with malignant bone tumors at the Orthopaedic Clinic of the University of Hamburg. The rotation-plasty was first published in 1930 by Borggreve. Salzer (Wien) described the method in 1981 for the operative treatment of osteosarcomas about the knee. The rotation-plasty is feasible for tumors of the distal femur, even when other limb-saving procedures are impossible, e.g. due to skip metastases, insufficient soft tissue coverage or involvement of the knee joint. The procedure was done on 26 female and 13 male patients, the age ranging between 7 and 45 years with a mean age of 17 years. The histological diagnosis was osteosarcoma in 36 cases, MFH, Ewing's sarcoma and Giant cell tumor in one case, respectively. The operative technique was slightly modified, compared to the method described originally by Salzer. The range of error of the different preoperative imaging procedures was evaluated and compared with the tumor extent in the resected specimen. MRI was found to be most precise. We saw no local recurrencies. Three patients had early thromboses, two of those had to be amputated, slow preoperative compression of the popliteal vein being the main cause in both. One patient developed a lymphatic fistula ten years postoperatively, which was eliminated in a second operation. All patients are followed routinely in the oncologic outpatient service. The functional results were rates "excellent" or "good" for all patients in six of seven categories, according to the Enneking evaluation system.(ABSTRACT TRUNCATED AT 250 WORDS)