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Bone Sarcoma pp 191–201Cite as

Bone Sarcomas in the Growing Child

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Part of the book series: MD Anderson Cancer Care Series ((MDCCS))

Chapter Overview

The most common primary tumors of bone occur most often in the ­skeletally immature patient. Historically, amputation was the procedure of choice, but improved oncologic outcomes and surgical advances have made limb-salvage therapy a feasible and valuable treatment option. However, the skeletally immature patient presents a unique group of surgical considerations. Not only may the size of the medullary canal be too small to accommodate a durable prosthesis, but also resection can create a limb-length discrepancy and gait abnormalities. Limb-salvage options available for the skeletally immature patient with a segmental long-bone defect include reconstruction with an expandable prosthesis or an intercalary autograft. A vascularized fibular transfer can preserve a limb’s growing potential. Amputations and rotationplasties can result in excellent function for appropriately chosen patients.

This chapter is adapted from Lewis VO, “Limb salvage in the skeletally immature patient,” Curr Oncol Rep 2005;7:285–292 (© 2005 by Current Science Inc.), with kind permission from Current Medicine Group LLC.

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Suggested Readings

  • Anderson MS, Green WT, Messner MB. Growth and predictions of growth in the lower extremities. J Bone Joint Surg Am. 1963;45-A:1–14.

    PubMed  CAS  Google Scholar 

  • Beebe K, Benevenia J, Kaushal N, Uglialoro A, Patel N, Patterson F. Evaluation of a noninvasive expandable prosthesis in musculoskeletal oncology patients for the upper and lower limb. Orthopedics. 2010;33:396.

    PubMed  Google Scholar 

  • Borggreve J. Kniegelenssersatz durch das in der Beinlngsachse um 180º gedrehte Fussgelenk. Arch Orthop Unfall-Chir. 1930;28:175–8.

    Article  Google Scholar 

  • Cammisa Jr FP, Glasser DB, Otis JC, et al. The Van Nes tibial rotationplasty. A functionally viable reconstructive procedure in children who have a tumor of the distal end of the femur. J Bone Joint Surg Am. 1990;72:1541–7.

    PubMed  Google Scholar 

  • Dominkus M, Windhager R, Kotz R. Treatment of malignant bone tumors in young children: complications and revisions. Acta Orthop Scand Suppl. 1997;276:4.

    Google Scholar 

  • Dominkus M, Krepler P, Schwameis E, et al. Growth prediction in extendable tumor prostheses in children. Clin Orthop. 2001;390:212–20.

    Article  PubMed  Google Scholar 

  • Eckardt JJ, Safran MR, Eilber FR, et al. Expandable endoprosthetic reconstruction of the skeletally immature after malignant bone tumor resection. Clin Orthop. 1993;297:188–202.

    PubMed  Google Scholar 

  • Eckardt JJ, Kabo JM, Kelley CM, et al. Expandable endoprosthesis reconstruction in skeletally immature patients with tumors. Clin Orthop. 2000;373:51–61.

    Article  PubMed  Google Scholar 

  • Gitelis S, Neel MD, Wilkins RM, et al. The use of a closed expandable prosthesis for pediatric sarcomas. Chir Organi Mov. 2003;88:327–33.

    PubMed  CAS  Google Scholar 

  • Gottsauner-Wolf F, Kotz R, Knahr K, et al. Rotationplasty for limb salvage in the treatment of malignant tumors at the knee. A follow-up study of seventy patients. J Bone Joint Surg Am. 1991;73:1365–75.

    PubMed  CAS  Google Scholar 

  • Gupta A, Meswania J, Pollock R, et al. Non-invasive distal femoral expandable endoprosthesis for limb-salvage surgery in paediatric tumours. J Bone Joint Surg Br. 2006;88:649–54.

    Article  PubMed  CAS  Google Scholar 

  • Hillmann A, Rosenbaum D, Gosheger G, et al. Rotationplasty type B IIIa according to Winkelmann: electromyography and gait analysis. Clin Orthop. 2001;384:224–31.

    Article  PubMed  Google Scholar 

  • Hoffman C, Hillmann A, Krakau H, et al. Functional results and quality of life measurements in patients with multimodal treatment of a primary bone tumor located in the distal femur. Rotationplasty versus endoprosthetic replacement. Med Pediatr Oncol. 1998;31:202–3.

    Google Scholar 

  • Horton G, Olney B. Epiphysiodesis of the lower extremity: results of percutaneous technique. J Pediatr Orthop. 1996;16:180–2.

    Article  PubMed  CAS  Google Scholar 

  • Innocenti M, Ceruso M, Manfrini M, et al. Free vascularized growth-plate transfer after bone tumor resection in children. J Reconstr Microsurg. 1998;14:137–43.

    Article  PubMed  CAS  Google Scholar 

  • Innocenti M, Delcroix L, Manfrini M, et al. Vascularized proximal fibular epiphyseal transfer for distal radial reconstruction. J Bone Joint Surg Am. 2004;86-A:1504–11.

    PubMed  Google Scholar 

  • Kaufman K, Miller L, Sutherland D. Gait asymmetry in patients with limb-length inequality. J Pediatr Orthop. 1996;16:144–50.

    Article  PubMed  CAS  Google Scholar 

  • Kenan S, Bloom N, Lewis MM. Limb-sparing surgery in skeletally immature patients with osteosarcoma. The use of an expandable prosthesis. Clin Orthop. 1991;270:223–30.

    PubMed  Google Scholar 

  • Kotz R, Salzer M. Rotation-plasty for childhood osteosarcoma of the distal part of the femur. J Bone Joint Surg Am. 1982;64:959–69.

    PubMed  CAS  Google Scholar 

  • Little D, Nigo L, Aiona M. Deficiencies of current methods for timing of epiphysiodesis. J Pediatr Orthop. 1996;16:173–9.

    Article  PubMed  CAS  Google Scholar 

  • McClenaghan BA, Krajbich JI, Pirone AM, et al. Comparative assessment of gait after limb-salvage procedures. J Bone Joint Surg Am. 1989;71:1178–82.

    PubMed  CAS  Google Scholar 

  • Menelaus MB. Correction of leg length discrepancy by epiphysial arrest. J Bone Joint Surg Br. 1966;48:336–9.

    PubMed  CAS  Google Scholar 

  • Menelaus M. The Anstey Giles lecture. Opening and closing the growth plate. Aust N Z J Surg. 1981;51:518–27.

    Article  PubMed  CAS  Google Scholar 

  • Moseley CF. A straight-line graph for leg-length discrepancies. J Bone Joint Surg Am. 1977;59:174–9.

    PubMed  CAS  Google Scholar 

  • Moseley CF. A straight line graph for leg length discrepancies. Clin Orthop. 1978;136:33–40.

    PubMed  Google Scholar 

  • Murray MP, Jacobs PA, Gore DR, et al. Functional performance after tibial rotationplasty. J Bone Joint Surg Am. 1985;67-A:392–9.

    Google Scholar 

  • Rosen G, Marcove RC, Huvos AG, et al. Primary osteogenic sarcoma: eight-year experience with adjuvant chemotherapy. J Cancer Res Clin Oncol. 1983;106(suppl):55–67.

    Article  PubMed  Google Scholar 

  • Scales JT, Sneath RS, Wright KWJ. Design and clinical use of extending prosthesis. In: Enneking WF, editor. Limb salvage in musculoskeletal oncology. New York: Churchill Livingstone; 1987. p. 52–61.

    Google Scholar 

  • Selber JC, Treadway C, Lopez A, Lewis VO, Chang DW. The use of free flap for limb salvage in children with tumors of the extremities. J Pediatr Surg. 2011;46:736–44.

    Article  PubMed  Google Scholar 

  • Simon MA, Springfield DS, editors. Surgery for bone and soft tissue sarcomas, vol. 1. New York: Lippincott Williams and Wilkins; 1998. p. 756.

    Google Scholar 

  • Simon MA, Aschliman MA, Thomas N, et al. Limb-salvage treatment versus amputation for osteosarcoma of the distal end of the femur. J Bone Joint Surg Am. 1986;68:1331–7.

    PubMed  CAS  Google Scholar 

  • Steenhoff JR, Daanen HA, Taminiau AH. Functional analysis of patients who have had a modified Van Nes rotationplasty. J Bone Joint Surg Am. 1993;75:1451–6.

    PubMed  CAS  Google Scholar 

  • Taylor GI, Wilson KR, Rees MD, et al. The anterior tibial vessels and their role in epiphyseal and diaphyseal transfer of the fibula: experimental study and clinical applications. Br J Plast Surg. 1988;41:451–69.

    Article  PubMed  CAS  Google Scholar 

  • Van Nes CP. Rotation-plasty for congenital defects of the femur. Making use of the ankle of the shortened limb to control the knee joint of a prosthesis. J Bone Joint Surg Am. 1950;32-B:12–6.

    Google Scholar 

  • Ward Sr WG, Yang RS, Eckardt JJ. Endoprosthetic bone reconstruction following malignant tumor resection in skeletally immature patients. Orthop Clin North Am. 1996;27:493–502.

    PubMed  CAS  Google Scholar 

  • Whelan JS. Osteosarcoma. Eur J Cancer. 1997;33:1611–8 [discussion 1618–9].

    Article  PubMed  CAS  Google Scholar 

  • Wilkins RM, Soubeiran A. The Phenix expandable prosthesis: early American experience. Clin Orthop. 2001;382:51–8.

    Article  PubMed  Google Scholar 

  • Winkelmann WW. Type-B-IIIa hip rotationplasty: an alternative operation for the treatment of malignant tumors of the femur in early childhood. J Bone Joint Surg Am. 2000;82:814–28.

    PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Oncology, Unit 1448, Division of Surgery, The University of Texas MD Anderson Cancer Center, 301402, Houston, TX, 77230, USA

    Valerae O. Lewis

  2. Department of Plastic Surgery, Unit 1488, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX, 77030, USA

    David W. Chang

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  1. Valerae O. Lewis
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  2. David W. Chang
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Correspondence to Valerae O. Lewis .

Editor information

Editors and Affiliations

  1. Division of Surgery, Department of Orthopedic Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, 77030, Texas, USA

    Patrick P. Lin

  2. Division of Cancer Medicine, Department of Sarcoma Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, 77030, Texas, USA

    Shreyaskumar Patel

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Lewis, V.O., Chang, D.W. (2013). Bone Sarcomas in the Growing Child. In: Lin, P., Patel, S. (eds) Bone Sarcoma. MD Anderson Cancer Care Series. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-5194-5_11

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  • DOI: https://doi.org/10.1007/978-1-4614-5194-5_11

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  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4614-5193-8

  • Online ISBN: 978-1-4614-5194-5

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