Skip to main content

Bone Tumors: Limb Salvage

  • Chapter
The Surgery of Childhood Tumors
  • 1100 Accesses

Abstract

Primary bone tumors in children are rare conditions, the upper limb being more rarely affected than the lower limb. The practicing general orthopedic surgeon may not see more than a single case of primary bone tumor per year. This rarity makes the recognition— particularly of malignant bone tumors—extremely difficult. Not surprisingly, this leads to difficulties and errors being made in specific treatment. With the establishment of bone tumor/cancer registries, the incidence of malignant primary disease of bone can be seen to be around six cases per million per year. The incidence of osteosarcoma, the most common primary malignant bone tumor, showing peak risks of incidence related to puberty is greatest between 10 and 14 years for girls and between 15 and 18 years for boys [1] (Fig. 16.1).

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

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 269.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 349.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Souhami RL, Cannon SR (1995) Osteosarcoma. In: Peckham M, Pinedo H, Veronessi U (eds) Oxford textbook of oncology, vol II. Oxford University Press, Oxford, pp 1960–1976

    Google Scholar 

  2. Cooper A (1918) Exostosis. In: Cooper A, Travers B (eds) Surgical essays, 3rd edn. Cox & Son, London, pp 169–226

    Google Scholar 

  3. Solomon L (1961) Bone growth in diaphyseal aclasis. J Bone Joint Surg 43B:700–716

    Google Scholar 

  4. Ollier M (1900) Dyschondroplasie. Lyon Med 93:23–25

    Google Scholar 

  5. Maffucci A (1881) Di un caso di enchondroma ed angiome multiplo. Mov Med Chir 13:399–412

    Google Scholar 

  6. Ellmore SM, Cantrell WC (1966) Maffucci’s syndromecase report with a normal karyotype. J Bone Joint Surg 48A:1607–1613

    Google Scholar 

  7. McGeogh CM, Varian JP (1985) Osteoclastoma of the first metacarpal. J Hand Surg (Br) 10:129–130

    Google Scholar 

  8. Simon MA, Kirchner PT (1980) Scintigraphic evaluation of primary bone tumours. J Bone Joint Surg 62A:758–764

    Google Scholar 

  9. Murray IP (1980) Bone scanning in the child and young adult. Skeletal Radiol 5:1–14

    PubMed  CAS  Google Scholar 

  10. Cohen M, et al. ( 1982) Lung CT of detection of metastases: Solid tissue neoplasms in children. Am J Radiol 139:895–898

    CAS  Google Scholar 

  11. Zimmer WD, Bergquist TH, McLeod RA, et al. (1985) Bone tumours: Magnetic resonance imaging versus computed tomography. Radiology 155:709–718

    PubMed  CAS  Google Scholar 

  12. Aiser AM, Martel W, Braunstein EM, et al. (1986) MRI and CT evaluation of primary bone and soft tissue tumours. Am J Roentgenol 146:749–756

    Google Scholar 

  13. Bohndorf K, Reiser M, Lochner B, et al. (1986) Magnetic resonance imaging of primary tumours and tumour-like lesions of bone. Skeletal Radiol 15:511–517

    PubMed  CAS  Google Scholar 

  14. Gillespy T III, et al. (1988) Staging of intraosseous extent of osteosarcoma. Radiology 167:765–767

    PubMed  Google Scholar 

  15. Dooms GC, Hricak H, Sollitto RA, Higgins CB (1985) Lipomatous tumours and tumours with fatty component: MR imaging potential and comparison of MR and CT results. Radiology 157:479–483

    PubMed  CAS  Google Scholar 

  16. Enneking WE (1982) Editorial: The issue of the biopsy. J Bone Joint Surg 64A:1119–1120

    Google Scholar 

  17. Mankin HJ, Lange TA Spanier SA (1982) The hazards of biopsy in patients with malignant primary bone and soft tissue tumours. J Bone Joint Surg 62A:1121–1127

    Google Scholar 

  18. Kreilbergs A, Bauer H, Brosjö O, et al. (1996) Cytological diagnosis of bone tumours. J Bone Joint Surg 78B:258–263

    Google Scholar 

  19. Stoker DJ, Cobb JP, Pringle JAS (1991) Needle biopsy of musculoskeletal lesions. J Bone Joint Surg 73B:498–500

    Google Scholar 

  20. Davies NM, Livesley PJ, Cannon SR (1993) Recurrence of osteosarcoma in a needle biopsy tract. J Bone Joint Surg 75B:977–978

    Google Scholar 

  21. Pringle JAS (1987) Pathology of bone tumours. Baillière’s Clin Oncol 1:21–63

    Google Scholar 

  22. Cannon SR, Dyson PHP (1987) The relationship of the location of open biopsy of malignant bone tumours to local recurrence after resection and prosthetic replacement. J Bone Joint Surg 69B:492

    Google Scholar 

  23. Enneking WE, Spanier SS, Goodman MA (1980) A system for the surgical staging of musculoskeletal sarcomata. Clin Orthop 153:106–120

    PubMed  Google Scholar 

  24. Broders AC (1964) The microscopic grading of cancer. In: Pack GT, Arrel IM (eds) Treatment of cancer and allied diseases. Hoeber, New York

    Google Scholar 

  25. Lewis RJ, Lotz MJ (1974) Medullary extension of osteosarcoma. Cancer 33:371–375

    PubMed  CAS  Google Scholar 

  26. Campanacci M, Baldini N, Boriani S, et al. (1987) Giant cell tumour of bone. J Bone Joint Surg 69A:106–114

    Google Scholar 

  27. Hadders HN (1973) Some remarks on the histology of bone tumours. Year Book Cancer Res (Amsterdam) 22:7–10

    Google Scholar 

  28. Saville PD (1980) A medical option for the treatment of osteoid osteoma. Arth Rheum 23:1409–1411

    CAS  Google Scholar 

  29. Leonessa C, Savoni E(1971) Osteoma osteoide para articulare del gomito. Chir Organic Mov 59:487–492

    CAS  Google Scholar 

  30. Marcove RC, Freiberger RH (1966) Osteoid osteoma of the elbow-a diagnostic problem. J Bone Joint Surg 48A:1185–1190

    Google Scholar 

  31. Shifrin LZ, Reynolds WA (1971) Intra-articular osteoid osteoma of the elbow. Clin Orthop 81:126–129

    PubMed  CAS  Google Scholar 

  32. Sim EH, Dahlin DC, Beabout JW (1975) Osteoid osteoma—diagnostic problems. J Bone Joint Surg 57A:154–159

    Google Scholar 

  33. Gamba JC, Martinez S, Apple J, et al. (1984) Computed tomography of axial skeletal osteoid osteomas. Am J Roentgenol 142:769–772

    CAS  Google Scholar 

  34. Szypryt EP, Hardy JG, Colton CL (1986) An improved technique of intra-operative bone scanning. J Bone Joint Surg 68B:643–646

    Google Scholar 

  35. Cannon SR, Briggs TWR, Johnson S, Remedios D (1998) Excision biopsy of osteoid osteoma under CT control, (in press)

    Google Scholar 

  36. Rosenthal DI, Springfield DS, Gebhardt MC, Rosenberg AE, Mankin HJ (1995) Osteoid Osteoma: Percutaneous radio-frequency ablation radiology Nov 197(2)451–454

    CAS  Google Scholar 

  37. Lepage J, Rigault P, Nezelof C, et al. (1984) Benign osteoblastoma in children. Rev Clin Orthop 70:117–127

    CAS  Google Scholar 

  38. Canepa G, Defabiani F (1965) Osteoblastoma del radio. Minerva Ortop 16:645–648

    PubMed  CAS  Google Scholar 

  39. Williams G, Barrett G, Pratt C (1977) Osteosarcoma in two very young children. Clin Paediat 16:548–551

    Google Scholar 

  40. Price CHG (1958) Primary bone-forming tumours and their relationship to skeletal growth. J Bone Joint Surg 40B:574–593

    Google Scholar 

  41. Simmons CC (1939) Bone sarcoma: Factors influencing prognosis. Surg Gycecol Obstet 68:67–75

    Google Scholar 

  42. Mankin HJ, Connor JF, Schiller AC, et al. (1985) Grading of bone tumours by analysis of nucleus DNA content using flow cytometry. J Bone Joint Surg 67A:404–413

    Google Scholar 

  43. Schreiman JS, Crass JR, Wick MR (1986) Osteosarcomarole of CT in limb-sparing treatment. Radiology 161:485–488

    PubMed  CAS  Google Scholar 

  44. Flowers JM Jr (1974) 99mTc-Polyphosphate up-take within pulmonary and soft tissue metastases from osteosarcoma. Radiology 112:377–378

    PubMed  Google Scholar 

  45. Stoker DJ, Cobb JP, Pringle JAS (1991) Needle biopsy of musculoskeletal lesions. J Bone Joint Surg 73B:498–500

    Google Scholar 

  46. Saifuddin A, Mann BS, Mahroof S, Pringle JA, Briggs TWR, Cannon SR (2005) Dedifferentiated Chondrosarcoma: Use of MRI to guide needle biopsy Clin Radiol 59(3)268–272

    Google Scholar 

  47. Sweetnam DR, Knowelden J, Seddon H (1971) Bone sarcoma—treatment by irradiation, amputation and a combination of the two. Brit Med J 2:363–367

    PubMed  CAS  Google Scholar 

  48. Cade S (1955) Osteogenic sarcoma: A study based in 133 patients. J R Coll Surg Edin 1:79–111

    CAS  Google Scholar 

  49. Beck JC, Wara WM, Bovill EG Jr, et al. (1976) The role of radiation therapy in the treatment of osteosarcoma. Radiology 120:163–165

    PubMed  CAS  Google Scholar 

  50. Rosen G, Tan C, Exelby P, et al. (1974) Vincristine, highdose methotrexate with citrovarum factor rescue, cyclophosphamide and Adriamycin cyclic therapy following surgery in childhood osteogenic sarcoma. Proc Am Assoc Cancer Res 15:172

    Google Scholar 

  51. Whelan J, Seddon B, Perisoglou M (2006) Management of Osteosarcoma. Curr Treat Options Oncol 7(6):444–455

    PubMed  Google Scholar 

  52. Geschickter CF, Copeland MM (1951) Parosteal osteosarcoma of bone: A new entity. Ann Surg 133:790–807

    PubMed  CAS  Google Scholar 

  53. Campanacci M, Picci P, Gherlinzoni F, et al. (1984) Parosteal osteosarcoma. J Bone Joint Surg 66B:313–321

    Google Scholar 

  54. Wold LE, Unni KK, Beabout JW, et al. (1984) Dedifferentiated parosteal osteosarcoma. J Bone Joint Surg 66A:53–59

    Google Scholar 

  55. Hall FM (1978) Periosteal sarcoma. Radiology 129:835–836

    PubMed  CAS  Google Scholar 

  56. Campanacci M, Giunti A (1976) Periosteal osteosarcoma-Review of 41 cases. Ital J Orthop Trauma 2:23–35

    CAS  Google Scholar 

  57. Grimer RJ, Bielack S, Flege S, Cannon SR, et al. (2005) Periosteal Osteosarcoma—A European review of outcome Eur J Cancer 41. 2806–2811

    PubMed  Google Scholar 

  58. Tomsu J, Procek J, Wagner K, et al. (1977) Vascular complications in osteochondromatosis. Rozhl Chir 56:696–699

    PubMed  CAS  Google Scholar 

  59. Fogel GR, McElfresh EC, Peterson HA, et al. (1984) Management of deformities of the forearm in multiple heredity osteochondromas. J Bone Joint Surg 66A:670–680

    Google Scholar 

  60. Hudson TM, Chew FS, Manaster BJ (1983) Scintigraphy of benign exostoses and exostotic chondrosarcomas. Am J Roentgenol 140:581–586

    CAS  Google Scholar 

  61. Jaffe HL, Lichtenstein C (1942) Benign chondroblastoma of bone. Am J Path 18:969–983

    Google Scholar 

  62. Higaki S, Takeyama S, Tateishi A, et al. (1981) Clinical pathological study of twenty-two cases of benign chondroblastoma. Nippon Seikeigeha Gahhai Zasshi 55:647–664

    CAS  Google Scholar 

  63. Bloem JL, Mulder JD (1985) Chondroblastoma: A clinical and radiological study of 104 cases. Skeletal Radiol 14:1–19

    PubMed  CAS  Google Scholar 

  64. Hudson TM, Hawkins IF Jr (1981) Radiological evaluation of chondroblastoma. Radiology 139:1–10

    PubMed  CAS  Google Scholar 

  65. Huvos AG, Marcove RC (1973) Chondroblastoma of bone-a critical review. Clin Orthop 95:300–312

    PubMed  Google Scholar 

  66. Rahimi A, Beabout JW, Ivins JC, et al. (1972) Chondro-myxoid fibroma-a clinical pathological study of 76 cases. Cancer 30:726–736

    PubMed  CAS  Google Scholar 

  67. Schajowicz F (1987) Chondromyxoid fibroma-a report of three cases with predominant cortical involvement. Radiology 164:783–786

    PubMed  CAS  Google Scholar 

  68. Gherlinzoni F, Rock M, Picci P (1983) Chondromyxoid fibroma. J Bone Joint Surg 65A:198–204

    Google Scholar 

  69. Marcove RC, Miké V, Hutter RVP, et al. (1972) Chondrosarcoma of the pelvis and the upper end of the femur. J Bone Joint Surg 54A:561–572

    Google Scholar 

  70. Kaufman JH, Douglass HO Jr, Blake W, et al. (1977) The importance of initial presentation and treatment upon the survival of patients with chondrosarcoma. Surg Gyn Obstet 145:357–363

    CAS  Google Scholar 

  71. Dahlin DC, Beabout JW (1971) Dedifferentiation of lowgrade chondrosarcoma. Cancer 28:461–466

    PubMed  CAS  Google Scholar 

  72. Lichenstein L, Bernstein D (1959) Unusual benign and malignant chondroid tumour of bone. Cancer 12:1142–1157

    Google Scholar 

  73. Bjornsson J, Unni KK, Dahlin DC, et al. (1984) Clear cell chondrosarcoma of bone-observations in 47 cases. Am J Surg Path 8:223–230

    PubMed  CAS  Google Scholar 

  74. Hutter RVP, Worcester JN Jr, Francis KC, et al. (1962) Benign and malignant giant cell tumours of bone. Cancer 15:653–610

    PubMed  CAS  Google Scholar 

  75. Singson R, Feldman F (1983) Case report 229: Diagnosis of multiple (multicentric) giant cell tumours of bone. Skeletal Radiol 9:276–281

    PubMed  CAS  Google Scholar 

  76. Campanacci M, Baldini N, Boriani S, et al. (1987) Giant cell tumour of bone. J Bone Joint Surg 69A: 106–114

    Google Scholar 

  77. Hadders HN (1973) Some remarks on the histology of bone tumours. Year Book Cancer Res (Amsterdam) 22:7–10

    Google Scholar 

  78. Tudway RC (1959) Giant cell tumour of bone. Brit J Radiol 32:315–321

    PubMed  CAS  Google Scholar 

  79. Nascimento AF, Huvos AG, Marcove RC (1979) Primary malignant giant cell tumour of bone. Cancer 44:1393–1402

    PubMed  CAS  Google Scholar 

  80. Johnson EW Jr (1965) Adjacent and distal spread of giant cell tumours. Am J Surg 109:163–166

    PubMed  Google Scholar 

  81. Kemp HBS, Cannon SR, Pringle J (1995) Shark-bite. A conservative surgical technique. British Orthopaedic Association, September, 1995

    Google Scholar 

  82. Caffey J (1955) On fibrous defects in cortical walls of growing tubular bones. Adv Pediatr 7:13–51

    PubMed  CAS  Google Scholar 

  83. Arata MA, Peterson HA, Dahlin DC (1956) Pathological fractures through non-ossifying fibromas. J Bone Joint Surg 63A:797–808

    Google Scholar 

  84. Cunningham JB, Ackerman LV (1956) Metaphyseal fibrous defects. J Bone Joint Surg 38A:797–808

    Google Scholar 

  85. Feldman F, Norman D (1972) Intra-and extra-osseous malignant histiocytoma. Radiology 104:497–508

    PubMed  CAS  Google Scholar 

  86. Ballance WA, et al. (1980) Osteogenic sarcoma. Malignant fibrous histiocytoma subtype. Cancer 62:763–771

    Google Scholar 

  87. Spanier SS, Enneking WF, Enriquez P (1975) Primary malignant fibrous histiocytoma of bone. Cancer 36:2084–2098

    PubMed  CAS  Google Scholar 

  88. Tang JSH, et al. (1988) Haemangiopericytoma of bone. Cancer 62:848–859

    PubMed  CAS  Google Scholar 

  89. Chow RW, Wilson CB, Olsen ER (1970) Angiosarcoma of the skull. Cancer 25:902–906

    PubMed  CAS  Google Scholar 

  90. Unni KK, et al. (1974) Adamantinoma of long bones. Cancer 34:1796–1805

    PubMed  CAS  Google Scholar 

  91. Huvos AG (1991) Ewing’s sarcoma. In: Huvos AG (ed) Bone tumours: Diagnosis, treatment and prognosis. WB Saunders, Philadelphia, pp 523–552

    Google Scholar 

  92. Price CHG, Jeffree GM (1977) Incidence of bone sarcoma in South West England 1946–1974. Brit J Cancer 36:511–522

    PubMed  CAS  Google Scholar 

  93. Glass AG, Fraimeni JFJR (1970) Epidemiology of bone cancer in children. J Natl Cancer Inst 44:187–199

    PubMed  CAS  Google Scholar 

  94. Dahlin DC (1978) Bone Tumours; General Aspects and Data on 6221 Cases. CC Thomas, Springfield Ill 274–287

    Google Scholar 

  95. Hayes FA, et al. (1987) Metastatic Ewing’s sarcoma remission, induction and survival. J Clin Oncol 5:1199–1204

    PubMed  CAS  Google Scholar 

  96. Glaubiger DL, et al. (1980) Determination of prognostic factors and their influence on therapeutic results in patients with Ewing’s sarcoma. Cancer 45:2213–2219

    PubMed  CAS  Google Scholar 

  97. Gehan EA, et al. (1981) Prognostic factors in children with Ewing’s sarcoma. Natl Cancer Inst Monogr 56:273–278

    PubMed  Google Scholar 

  98. Gobel V, et al. (1987) Prognostic significance of tumour volume in localised Ewing’s sarcoma of bone in children and adolescents. J Cancer Res Clin Oncol 113:187–191

    PubMed  CAS  Google Scholar 

  99. Nascimento AG (1980) A clinicopathologic study of 20 cases of large cell (atypical) Ewing’s sarcoma of bone. Am J Surg Pathol 4:29–36

    PubMed  CAS  Google Scholar 

  100. Jurgens H, et al. (1988) Multidisciplinary treatment of primary Ewing’s sarcoma of bone. Cancer 61:23–32

    PubMed  CAS  Google Scholar 

  101. Miser JS, et al. (1988) Preliminary results of treatment of Ewing’s sarcoma of bone in children and young adults. J Clin Oncol 6:484–490

    PubMed  CAS  Google Scholar 

  102. Soule EH, Newton W Jr, Moon TE (1978) Extraskeletal Ewing’s sarcoma: A preliminary review of 26 cases encountered in the Intergroup Rhabdomyosarcoma Study. Cancer 42:259–264

    PubMed  CAS  Google Scholar 

  103. Donaldson SS (1981) A story of continuing success—Radiotherapy for Ewing’s sarcoma. Int J Radiat Oncol Biol Phys 7:279–281

    PubMed  CAS  Google Scholar 

  104. Sauer R, Jurgens H, Burgers JM (1987) Prognostic factors in the treatment of Ewing’s sarcoma. Radiother Oncol 10:101–110

    PubMed  CAS  Google Scholar 

  105. Kinsella TS, et al. (1984) Local treatment of Ewing’s sarcoma: Radiation therapy versus surgery. Cancer Treat Rep 68:695–701

    PubMed  CAS  Google Scholar 

  106. Li WK, et al. (1983) Pelvic Ewing’s sarcoma: Advances in treatment. J Bone Joint Surg 65A:738–747

    Google Scholar 

  107. Dunst J, Sauer R, Burgers JM (1988) Radiotherapie beim Ewing’s sarkom. Klin Pädiatr 200:261–266

    PubMed  CAS  Google Scholar 

  108. Johnston CE II, Fletcher RR (1986) Traumatic transformation of unicameral bone cyst into aneurysmal bone cyst. Orthopedics 9:1441–1477

    PubMed  Google Scholar 

  109. Campanacci M, Capanna R, Picci P (1986) Unicameral and aneurysmal bone cysts. Clin Orthop 204:35–36

    Google Scholar 

  110. Norman A, Schiffman M (1977) Simple bone cysts: Factors of age dependency. Radiology 124:779–782

    PubMed  CAS  Google Scholar 

  111. Dyer R, Stelling CB, Fechner RE (1981) Epiphyseal extension of an aneurysmal bone cyst. Am J Roentgenol 137:153–168

    Google Scholar 

  112. Wang CC, Schulz MD (1953) Ewing’s sarcoma. A study of fifty cases treated at the Massachusetts General Hospital, 1930–1952 inclusive. New Engl J Med 248:571–576

    PubMed  CAS  Google Scholar 

  113. Biesecker JL, Marcove RC, Huvos AG, et al. (1970) Aneurysmal bone cysts. A clinicopathologic study of 66 cases. Cancer 26:615–625

    PubMed  CAS  Google Scholar 

  114. Ackermann L, Ramamurthy S, Jablokow V, et al. (1988) Case report 488: Post-traumatic myositis ossificans mimicking a soft tissue neoplasm. Skeletal Radiol 17:310–314

    Google Scholar 

  115. Burwell RG (1964) Studies in the transplantation of bone: VII the fresh composite homograft/autograft of cancellous bone. An analysis of factors leading to osteogenesis in marrow transplants and in marrow containing bone grafts. J Bone Joint Surg 46B: 110

    Google Scholar 

  116. Ilizarov GA, Ledidroev VI (1969) Replacement of defects of long tubular bones by means of one of their fragment. Vestn Klin 102:77–84

    CAS  Google Scholar 

  117. De Bastiani G, Aldegheri R, Renzo Brivio L, Trivella G (1987) Limb lengthening by callus distraction (callotasis). J Pediatr Orthop 7:129–134

    PubMed  Google Scholar 

  118. Sim FH, Ivins JC, Taylor WF, Chao EYS (1985) Limb-sparing surgery for osteosarcoma: Mayo Clinic experience. Cancer Treat Sym 3:139–154

    Google Scholar 

  119. Lane JM, Glasser DB, Duane K, Healey JH, McCormack RR Jr, et al. (1987) Osteogenic sarcoma: Two hundred thirty-three consecutive patients treated with neoadjuvant chemotherapy. Orthop Trans 11:495

    Google Scholar 

  120. Winkler K, Beron G, Kotz R, Salzer-Kuntschik M, Beck J, et al. ( 1984) Neoadjuvant chemotherapy for osteogenic sarcoma. Results of a co-operative German/Austrian study. J Clin Oncol 2:617–624

    PubMed  CAS  Google Scholar 

  121. Simon MA, Aschliman MA, Neal T, Mankin HJ (1986) Limb-salvage treatment versus amputation for osteosarcoma of the distal end of the femur. J Bone Joint Surg 68A:1331–1337

    Google Scholar 

  122. Bramwell VH, Burgers M, Sneath R, et al. (1992) A comparison of two short intensive adjuvant chemotherapy regimes in operable osteosarcoma of limbs in children and young adults. J Clin Oncol 10:1579–1591

    PubMed  CAS  Google Scholar 

  123. Simon MA (1988) Current concepts review: Limb salvage for osteosarcoma. J Bone Joint Surg 70A:307–310

    Google Scholar 

  124. Buck BE, Malinin TI, Brown MD (1989) Bone transplantation and human immunodeficiency virus. An estimate of risk of acquired immunodeficiency syndrome (AIDS). Clin Orthop 240:129–136

    PubMed  Google Scholar 

  125. Musculo DL, et al. (1987) Tissue typing in human massive allografts of frozen bone. J Bone Joint Surg 69A:583–595

    Google Scholar 

  126. Berry BH, Lord CF, Gebhardt MC, Mankin HJ (1990) Fractures of allografts. J Bone Joint Surg 72A:825–833

    Google Scholar 

  127. O’Connor MI, Rock MG, Sim FH, Chao EYS (1991) Limb salvage of the proximal humerus: Reconstruction with osteoarticular allograft versus endoprosthesis. In: Brown KLB (ed) Complications of limb salvage ISOCS, Montreal, pp 105–108

    Google Scholar 

  128. Gebhardt MC, Roth YF, Mankin HJ (1990) Osteoarticular allografts for reconstruction in the proximal part of the humerus after excision of a musculoskeletal tumour. J Bone Joint Surg 72A:334–345

    Google Scholar 

  129. Capanna R, Manfrini M, Ceruso M, Angeloni R, Lauris G, et al. (1991) A new reconstruction for metadiaphyseal resections: A combined graft (allograft shell plus vascularised fibula)—preliminary results. In: Brown KLB (ed) Complications of limb salvage. ISOCS, Montreal, pp 319–321

    Google Scholar 

  130. Mankin HJ, Dopperts S, Tomford W (1983) Clinical experience with allograft implantation: The first ten years. Clin Orthop 174:69–86

    PubMed  Google Scholar 

  131. Urbaniak JR, Black KE Jr (1985) Cadaveric elbow allografts: A six year experience. Clin Orthop 197:131–140

    PubMed  Google Scholar 

  132. Cannon SR, Briggs TWR, Blunn G, Unwin P (2005) Endoprosthetic reconstruction of the proximal humerus using a constrained bi-articular prosthesis. Proceedings of the 13th International Symposium on Limb Salvage, Seoul, Korea, September 7–10, 2005

    Google Scholar 

  133. Gupta A, Meswania J, Pollock R, Cannon SR, Briggs TWR, Taylor S, Blunn G (2006) Non-invasive distal femoral expandable endoprosthesis for limb salvage surgery in paediatric tumours. J Bone Joint Surg Br (5) 649–654

    Google Scholar 

  134. Marsden W, Stephens F, Waugh R, McCarthy S (1991) Soft tissue complications of intra-arterial chemotherapy: Definition, prevention and treatment. In: Brown KLB (ed) Complications of limb salvage. ISOCS Montreal, pp 313–317

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Cannon, S.R. (2008). Bone Tumors: Limb Salvage. In: Carachi, R., Grosfeld, J.L., Azmy, A.F. (eds) The Surgery of Childhood Tumors. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-29734-5_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-29734-5_16

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-29733-8

  • Online ISBN: 978-3-540-29734-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics