Rotation-plasty for childhood osteosarcoma of the distal part of the femur.

A rotation-plasty procedure was used in four children with osteosarcoma of the distal part of the femur. The results showed that this procedure, combined with en bloc wide excision of the proximal part of the tibia and the distal part of the femur including the knee joint, appears to be an adequate surgical treatment for osteosarcoma of the distal part of the femur in children. None of our patients to date had either clinical or radiographic evidence of local recurrence during follow-up periods of between twenty-seven and fifty-eight months. One patient, however, died of widespread metastatic disease. Despite postoperative adjuvant chemotherapy with high doses of methotrexate, there have been no problems with wound-healing and early fitting of a prosthesis was possible. Because of the success in preventing local recurrence in these four patients, we now generally employ this method in the surgical management of osteosarcoma of the distal part of the femur in children.