Skip to main content
Log in

The accuracy of free hand resection in limb salvage surgery of bone tumours

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

Resection length should be designed before limb salvage surgery of bone tumours. The aim of this study was to evaluate the accuracy of free hand resections.

Methods

Two hundred forty-eight cases were enrolled, including 173 osteosarcomas, 24 giant cell tumours, 16 chondrosarcomas, seven spindle cell sarcomas, 14 bone metastases, three undifferentiated pleomorphic sarcomas, three Ewing sarcomas, two angiosarcomas, and six other bone and soft tissue tumours. One hundred forty-six were located in the femur, 75 in the tibia, 19 in the humerus, six in the radius, one in the ulna, and one in the fibula. The resection length was included in the pre-operative plan. After surgery, we measure the length of specimens. Both lengths were compared. The patients were classified by tumour location.

Results

The range of length difference was from − 21 to 29 mm. The mean absolute value of the differences was 8.0 ± 6.3 mm. Altogether, 173 cases (69.8%) had an absolute difference value of ≤ 10 mm, 66 cases (26.6%) of 10−20 mm, and only 9 cases (3.6%) of > 20 mm. The average length of gross specimens (164.1 ± 43.3 mm) was longer than planned lengths (160.7 ± 44.2 mm); p < 0.001.

Conclusions

The differences were significant in the distal femur and proximal tibia. Even though, the accuracy of free hand resection is acceptable in this method.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Karakousis CP, Emrich LJ, Rao U, Krishnamsetty RM (2015) Feasibility of limb salvage and survival in soft tissue sarcomas. Cancer 57(3):484–491

    Article  Google Scholar 

  2. Rougraff BT, Simon MA, Kneisl JS, Greenberg DB, Mankin HJ (1994) Limb salvage compared with amputation for osteosarcoma of the distal end of the femur. A long-term oncological, functional, and quality-of-life study. Journal of Bone & Joint Surgery American 76(5):649

    Article  CAS  Google Scholar 

  3. Mankin HJ, Gebhardt MC, Jennings LC, Springfield DS, Tomford WW (1996) Long-term results of allograft replacement in the management of bone tumors. Clinical Orthopaedics & Related Research 324(324):86

    Article  Google Scholar 

  4. Peh WC (1999) The role of imaging in the staging of bone tumors. Crit Rev Oncol Hematol 31(2):147–167

    Article  PubMed  CAS  Google Scholar 

  5. Hudson TM, Schiebler M, Springfield DS, Hawkins I Jr, Enneking WF, Spanier SS (1983) Radiologic imaging of osteosarcoma: role in planning surgical treatment. Skelet Radiol 10(3):137

    Article  CAS  Google Scholar 

  6. Kawaguchi N, Ahmed AR, Matsumoto S, Manabe J, Matsushita Y (2004) The concept of curative margin in surgery for bone and soft tissue sarcoma. Clinical Orthopaedics & Related Research 419(419):165

    Article  Google Scholar 

  7. O’Flanagan SJ, Stack JP, Mcgee HM, Dervan P, Hurson B (1991) Imaging of intramedullary tumour spread in osteosarcoma. A comparison of techniques. Journal of Bone & Joint Surgery British Volume 73(6):998

    Article  Google Scholar 

  8. Hermann G, Rose JS, Strauss L (1984) Tumor infiltration of the bone marrow: comparative study using computed tomography. Skelet Radiol 11(1):17–21

    Article  CAS  Google Scholar 

  9. Deng ZP, Liu BY, Sun Y, Jin T, Li B, Ding Y et al (2017) Transition from tumor tissue to bone marrow in patients with appendicular osteosarcoma after neoadjuvant chemotherapy. Chin Med J 130(18):2215

    Article  PubMed  PubMed Central  Google Scholar 

  10. Cho HS, Oh JH, Han I, Kim HS (2012) The outcomes of navigation-assisted bone tumour surgery: minimum three-year follow-up. Journal of Bone & Joint Surgery British Volume 94(10):1414–1420

    Article  CAS  Google Scholar 

  11. Wong KC, Kumta SM, Antonio GE, Tse LF (2008) Image fusion for computer-assisted bone tumor surgery. Clinical Orthopaedics & Related Research 466(10):2533

    Article  Google Scholar 

  12. Wong KC, Kumta SM (2013) Computer-assisted tumor surgery in malignant bone tumors. Clinical Orthopaedics & Related Research® 471(3):750–761

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Xiaohui Niu.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, B., Deng, Z. & Niu, X. The accuracy of free hand resection in limb salvage surgery of bone tumours. International Orthopaedics (SICOT) 42, 1999–2002 (2018). https://doi.org/10.1007/s00264-018-3825-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-018-3825-y

Keywords

Navigation