Original Articles OUTCOME OF LOWER EXTREMITY SALVAGE WITH IPSILATERAL VASCULARIZED FIBULA AFTER TIBIAL BONE TUMOR RESECTION IN PEDIATRIC AGE GROUP

Abstract

Background:

Malignant bone tumors are difficult to diagnose at every level of pubertal growth in children and such defects are challenging to reconstruct. The purpose of this study was to report clinical characteristics and outcomes of limb-sparing surgeries in a series of pediatric patients after resection of tibia sarcoma using the TESS questionnaire.

Material and methods:

In this study, we retrospectively reviewed data of patients having tibial sarcoma, who underwent salvage of lower extremity with ipsilateral vascularized fibula after tibia tumor resection from July 2016 to July 2017 with follow up till July 2019, retrieved from hospital database software. We collected demographic, oncological data, reconstructive data, complications, and outcome during a 2-years follow-up. Morbidity was assessed by the number of hospital visits during the followup period.

Results:

 Single staged tribalization of the fibula was done in all 7 pediatric patients who had the age of 12±2.4 years and among them 5(71.4%) were male. Out of 7 patients, 5(71.4%) had Osteosarcoma with the mean ± SD size of the defect after tumor resection being 13±2.6 cm. Weight-bearing in 5(71.4%) patients, was started at 6 months. Mean ± SD TESS at 3 months, 6 months, 1 year, and at 2 years showed gradual improvement in daily routine activities of the patient (p<0.001). Mild hypertrophy was observed in 4(57.2%) patients who had no complications after 2 years.

Conclusion:

 Single-stage pedicled ipsilateral fibula transposition for tibial segmental defect has fewer complications with better outcome making it the procedure of choice for tibia reconstruction.