Technique and complications of callus distraction in the treatment of bone tumors

• Published in: Archives of orthopaedic and trauma surgery 2006-04, Vol.126 (3), p.157-163
• Main Authors: Kapukaya, Ahmet, Subasi, Mehmet, Arslan, Huseyin, Tuzuner, Tolga, Selek, Suat
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Bone cancer; Bone Neoplasms - drug therapy; Bone Neoplasms - surgery; Chemotherapy; Child; Combined Modality Therapy; Defects; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Osteogenesis, Distraction - methods; Patients; Postoperative Complications; Salvage Therapy - methods; Treatment Outcome
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-006-0123-8

This study investigated the effects of chemotherapy, defect length, and patient age on the outcome and complications of callus distraction as a limb salvage technique in 17 patients. The mean patient age was 18.4 years (range 7-47). Of 17 patients, 8 received chemotherapy and the remaining 9 patients did not. The mean defect length after excision of the lesion was 13 cm (range 8-20). The mean follow-up period for the patients whose treatments were completed was 55 months (range 20-90), the mean distraction index was 12.55 days/cm (range 11-15.7), and the mean external fixation index was 34.73 days/cm (range 30-41). In two patients, local recurrence occurred before distraction was completed. Two patients died, and one of them was a patient in whom local recurrence had occurred. Complications included non-union in one patient, osteomyelitis in one patient, and premature callus, osseous bridge, and varus of the femur in one patient. The extremity functional score was 80% (range 26-100). Chemotherapy and defect length had no significant effect on the distraction or external fixation indices. In contrast, the increase in the external fixation index in those over 20 years old was significant (P=0.043). We found that chemotherapy and defect length have no significant effect on the outcome and complications with this technique, which was more successful in patients younger than 20 years.