Place of resection in the management of primary bone tumours.

A primary malignant sarcoma of bone in an extremity must be removed so that it will not recur locally. Amputation will accomplish this in most cases but a prosthesis is required. In carefully selected cases of malignant giant cell tumour, low-grade chondrosarcoma, low-grade fibrosarcoma, parosteal osteogenic sarcoma and adam-antinoma, resection with insertion of an autograft, allograft or metallic implant has been successful. More recently implants have been used following resection of the more malignant tumours such as osteosarcoma, high-grade fibrosarcoma and high-grade chondrosarcoma, but further time is required to determine the problems secondary to chemotherapy, other complications, the length of time for rehabilitation, and the quality of life after this procedure as compared with the more conventional amputation with early prosthetic titting.