Masood Umer1, Raza Askari1, Sher Baz1. 1. Department of Surgery (Orthopedics), The Aga Khan University Hospital, Karachi, Pakistan.
Abstract
OBJECTIVE: To share early experience with paediatric patients having undergone skeletal reconstruction after limb salvage surgery. METHODS: A reterorespective audit study was conducted at Aga Khan University Hospital, Karachi, from 1994 to 2011 An audit of the institutional tumour registry was done and relevant cases of paediatric patients having undergone skeletal reconstruction after limb salvage surgery were tracked. Outcomes were objectively assessed through Musculoskeletal Tumour Society score. International Society of Limb Salvage grading was used to measure union of the graft to the host bone. RESULTS: Of the total 9 patients, 5(55.6%) were males and 4(44.4%) were females with an overall mean age of 11±3 SD years (range: 7-14 years). Six (66.7%) cases involved lower limbs, while 2(22.2%) cases involved upper limbs. The mean follow-up was 41±3SD months (range: 14-204 months). There was no tissue reaction observed locally or systemically. No local recurrence was seen. Mean Musculoskeletal Tumor Society score was 21.2±3 SD and International Society Of Limb Salvage grading was excellent in 5(55.5%) patients and good in 2(22.2%). One (11.1%) fibula fractured due to non-union at the proximal site. One (11.1%) patient died of the disease. Donor site morbidity was minimum except a big toe drop in 1(11%) case. CONCLUSIONS: Parental fresh fibular allografts provide a good alternative for skeletal reconstruction. Donor site morbidity was minimal.
OBJECTIVE: To share early experience with paediatric patients having undergone skeletal reconstruction after limb salvage surgery. METHODS: A reterorespective audit study was conducted at Aga Khan University Hospital, Karachi, from 1994 to 2011 An audit of the institutional tumour registry was done and relevant cases of paediatric patients having undergone skeletal reconstruction after limb salvage surgery were tracked. Outcomes were objectively assessed through Musculoskeletal Tumour Society score. International Society of Limb Salvage grading was used to measure union of the graft to the host bone. RESULTS: Of the total 9 patients, 5(55.6%) were males and 4(44.4%) were females with an overall mean age of 11±3 SD years (range: 7-14 years). Six (66.7%) cases involved lower limbs, while 2(22.2%) cases involved upper limbs. The mean follow-up was 41±3SD months (range: 14-204 months). There was no tissue reaction observed locally or systemically. No local recurrence was seen. Mean Musculoskeletal Tumor Society score was 21.2±3 SD and International Society Of Limb Salvage grading was excellent in 5(55.5%) patients and good in 2(22.2%). One (11.1%) fibula fractured due to non-union at the proximal site. One (11.1%) patient died of the disease. Donor site morbidity was minimum except a big toe drop in 1(11%) case. CONCLUSIONS: Parental fresh fibular allografts provide a good alternative for skeletal reconstruction. Donor site morbidity was minimal.