Resection And TSRH Reconstruction For Tumors Of Iliac Bone

Objective To evaluate the methods of the TSRH fixation system combined with bone or polymethylmethacrylate (PMMA) for the reconstruction of pelvic girdle after the complete resections of primary malignant bone tumor and the metastatic lesion of ilium. Methods From March 2002 to July 2006, 15 patients with iliac malignant bone tumor were treated with the techniques of the complete resection and reconstruction. There were 6 males and 9 females at the age of 11 to 62 years. The 12 patients with primary malignant bone tumor included 4 cases of chondrosar- comas, 3 cases of osteosarcomas, 2 cases of Ewing sarcomas, and 2 cases of giant cell tumor of bone, 1 case of angioendothe- lioma. The 3 patients with the metastatic lesion consisted of 1 cases ofbreast carcinoma, 1 case of liver cancer, 1 case of thyroid carcinoma. A solitary skeletal metastatic lesion was demonstrated in all metastases cases. The TSRH fixation system combined with bone was used to reconstruct the pelvic girdle in primary malignant tumor. The patients with metastases underwent the TSRH system fixation with PMMA or without PMMA. The postoper- ative complication of reconstruction and local recurrence were investigated. The postoperative function was analyzed according to the ISOLS. Results The average follow up was 25 months (8 to 60 months). Of all patients, 2 had suspected deep infection, There was 1 patients with local recurrences, 1 patients with pulmona- ryy metastases and 1 death due to metastases. After surgical intervention, no infection occurred in Three metastases patients. All patients immediately alleviated the pain and could walk with or without support after operation. The mean healing time of the osteotomy site was 5.8 months(4 to 7.8 months) in 7 patients, No immune rejection was seen .The average functional score was 21.2 in 14 survival. Conclusion Because of less complication and good function, the TSRH fixation system combined with bone or PMMA are advisable for the reconstructions of pelvic stability after the complete iliac resections of primary malignant bone tumor and the metastatic lesion.