CORR Insights^®: Is the Induced-membrane Technique Successful for Limb Reconstruction After Resecting Large Bone Tumors in Children?

Excerpt

The treatment of children with malignant bone tumors has improved dramatically during the last 40 years. With improvements in multiagent chemotherapy, and advances in surgical techniques, limb salvage has become the standard treatment option. Several reconstruction approaches are employed to provide a functional and durable extremity. Although initial studies confirm that limb-salvage surgery carries no greater risk of local recurrence or mortality compared with amputation [6], complications are common, and concerns about late revisions in this patient population remain [4]. Skeletal reconstruction with prosthetic components, large-allograft bone segments, autograft techniques, free fibula transfers, and novel autograft procedures (such as the “turn-downplasty” knee arthrodesis [9]) all have had some success. However, durable and functional reconstructions can be difficult to obtain, particularly in children. A biological answer for skeletal reconstruction would be to replace the missing segment with living bone, which could remodel and strengthen in time. This is thought to be an attractive approach. …