Clinical Research On Evaluation Of Fibular Head Resection In Prosthetic Replacement For Neoplasms Of Proximal Tibia In Limb Salvage Surgery

Objective:To study on the effects of fibular head resection in prosthetic replacement for neoplasms of proximal tibia in limb salvage surgery.Methods:In July1999-March2013,76patients suffered neoplasms of proximal tibia were involved in the study, and all of the patients underwent tumor resection, prosthetic replacement and gastrocnemius mucocutaneous flap transfer. Among them,38patients underwent fibular head resection (Group A) and the rest were Group B. Intra-operative and post-operative events were observed to analyze the effects of fibular head resection, applied American society for bone tumors scoring system (MSTS93) to evaluate the joint function. Results:All patients were follow-up visited, we found that2.63%of patients in Group A occurred subcutaneous soft tissue infection, which is lower than15.79%in Group B markedly(P<0.05),2.63%in group A and5.26%in Group B were found medial head of the gastrocnemius necrosis. Four and two in Group A and six and four in Group B occurred prosthetic loosening and instability of the knee, respectively.7.89%and13.16%occurred local recurrence,18.42%and15.79%occurred distant metastasis,21.05%and18.42%were dead in Grouop A and Group B, respectively. Knee score were analysised by MSTS93was86.84%and84.21%in Group A and Group B,respectively (P=0.744).Conclusion:Fibular head resection in prosthetic replacement for neoplasms of proximal tibia in limb salvage surgery will benefit to intra-operative tissue coverage, and will reduce trauma by skin transplantation and related complications. Of note, stability and motion of joint were not affected after operation.