Page 172 - Reconstructive Techniques in Musculoskeletal Tumor Surgery

Chapter 8
Table 1. continued
Variable
Reconstruction site
Femur
Tibia
Adjuvant therapies
Chemotherapy
None
Radiotherapy
Chemo- and radiotherapy
Osteosynthesis type
Single plate
Double plate Intramedullary nail + plate
Status at nal follow-up
No evidence of disease Alive with disease Died of disease
Study data
Number Percent
39 68 18 32
34 60 19 33 2 4 2 4
31 54 23 40 3 5
46 81 1 2 10 18
Median age at surgery was 17 years (range, 2-71 years). Predominant diagnoses were osteosarcoma (n=26, 46%), adamantinoma, and Ewing sarcoma (both; n=9, 16%) (table 1). At follow-up, 46 patients (81%) had no evidence of disease, one patient (2%) was alive with disease, and ten (18%) had died due to disease. Sixty- one osteotomies (64%) were located in the femur, 35 (37%) in the tibia. Sixty- ve osteotomies (68%) were diaphyseal, 31 (32%) were meta-epiphyseal. Fifty-six osteotomies (58%) were subjected to (neo)adjuvant chemotherapy, two (2%) to radiotherapy, and two (2%) to both. Osteosynthesis was performed with a single long plate held with cortical screws in 53 osteotomies (55%), with a long plate combined with a separate smaller plate in 39 (41%), and with a plate combined with a nail in four (4%).
Ethics and statistical analysis
All study procedures were in accordance with the ethical standards of Dutch law (Medical Research involving Human Subjects Act) and with the 1964 Helsinki declaration and its later amendments. For this type of study formal consent is not required.
All data were complete. Logistic regression analyses were used to assess the in uence of potential risk factors of the occurrence of nonunion. Outcomes are
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