Over 10-year follow-up of functional outcome in patients with bone tumors reconstructed using distraction osteogenesis

J Orthop Sci. 2013 Jan;18(1):101-9. doi: 10.1007/s00776-012-0327-4. Epub 2012 Oct 25.

Abstract

Background: The aim of this study was to investigate the long-term functional capabilities of patients who underwent bone distraction for the treatment of bone defects caused by bone tumor excision.

Methods: Bone distraction was indicated for patients with stage IIB malignant bone tumors when chemotherapy was judged to be effective and an epiphysis could be preserved or for patients with low-grade or aggressive benign bone tumors. Twenty-two patients who underwent reconstruction with bone distraction and were followed up for at least 10 years were retrospectively investigated. Patients included 8 males and 14 females, with a mean age of 25.3 years. Tumor types included seven osteosarcomas, two osteofibrous dysplasias, one Ewing's sarcoma, five low-grade osteosarcomas, two adamantinomas, and five giant cell tumors. Chemotherapy was performed during bone distraction in 8 cases. Bone transport was used in 17 cases, while shortening distraction was used in 5 cases.

Results: The mean distraction length was 8.1 cm, and the mean external fixation period was 301 days. The average Musculoskeletal Tumor Society score (used to measure functional outcome) was 91.5 % at mean follow-up of 202 months. Fourteen patients were able to play sports without any difficulty.

Conclusions: Epiphyseal preservation and reconstruction by bone distraction require both time and effort, but can provide excellent long-term outcomes, resulting in a stable reconstruction that functionally restores the natural limb.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Neoplasms / physiopathology
  • Bone Neoplasms / surgery*
  • Child
  • Child, Preschool
  • Exercise / physiology*
  • External Fixators*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Motor Activity / physiology*
  • Osteogenesis, Distraction / instrumentation*
  • Plastic Surgery Procedures / methods*
  • Recovery of Function*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult