Abstract
Nine patients with Ewing's sarcomas and seven patients with osteosarcoma of the fibula were treated surgically. The bone defect after tumour resection ranged from 5 to 25 cm (median 14 cm). Ten sarcomas were located in the proximal and six in the diaphyseal or distal fibula. Nine of ten patients with sarcomas located in the proximal fibula underwent a resection of the tumour including the common peroneal nerve. In one patient with a tumour in the proximal fibula, the peroneal nerve was preserved; however, this patient underwent amputation because of surgery with an intralesional margin. In five patients with a tumour in the distal fibula, the peroneal nerve was preserved. However, two of these five patients underwent amputation as an adequate surgical margin could not be achieved during resection. All ten patients in whom the peroneal nerve was resected achieved satisfactory function by wearing a peroneal brace. In patients with Ewing's sarcoma of the proximal fibula, preservation of the common peroneal nerve may be chosen as an alternative possibility of resection.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Dahlin DC, Unni KK (1986) Bone tumors. General aspects and data on 8542 cases, 4th edn. Thomas, Springfield
Enneking WF (1987) Modification of the system for functional evaluation of surgical management of musculoskeletal tumors. In: Enneking WF (ed) Limb salvage in musculoskeletal oncology, Bristol-Myers/Zimmer Orthopaedic Symposium. Churchill Livingstone, New York, pp 626–682
Enneking WF, Spanier SS, Goodman MA (1980) A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop 153:106–120
Huvos AG (1991) Bone tumor. Diagnosis, treatment, and prognosis, 2nd edn. WB Saunders, Philadelphia
Jurgens H, Exner U, Gadner H, Harms D, Michaelis J, Sauer R, Treuner J, Voute T, Winkelmann W, Winkler K, Göbel U (1988) Multidisciplinary treatment of primary Ewing's sarcoma of bone. A 6-year experience of European cooperative trial. Cancer 61:23–31
Jurgens H, Treuner J, Winkler K, Göbel U (1989) Ifosfamide in pediatric malignancies. Semin Oncol 16:46–50
Lushiku HB, Gebhart M (1995) Osteosarcoma of fibula: report of 3 cases. (Abstract 126) Joint Meeting EMSOS-AMSTS, May 8th–9th, Florence
Malawer MM (1984) Surgical management of aggressive and malignant tumors of the proximal fibula. Clin Orthop 186: 172–181
Norman-Taylor FH, Sweetnam DIS, Fixsen JA (1994) Distal fibulectomy for Ewing's sarcoma. J Bone Joint Surg [Br] 76: 559–562
Ozaki T, Hillmann A, Hoffmann C, Rube C, Blasius S, Dunst J, Jürgens H, Winkelmann W (1996) Significance of surgical margin on prognosis of patients with Ewing's sarcoma. Cancer 78:892–900
Winkler K, Bielack S, Delling G, Salzer-Kuntschik M, Kotz R, Greenshaw C, Jürgens H, Ritter J, Kusniert-Glaz C, Erttmann R, Gädicke G, Graf N, Landenstein R, Leyvraz S, Mertens R, Weinel P (1990) Effect of intraarterial versus intravenous cisplatin in addition to systemic doxorubicin, high-dose methotrexate, and ifosfamide on histologic tumor response in osteosarcoma (study COSS-86). Cancer 66:1703–1710
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ozaki, T., Hillmann, A., Lindner, N. et al. Surgical treatment of bone sarcomas of the fibula Analysis of 19 cases. Arch Orthop Trauma Surg 116, 475–479 (1997). https://doi.org/10.1007/BF00387580
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00387580