Reconstruction of defects following bone tumor resections by distraction osteogenesis

Introduction The authors present the results of nine patients ( two females, seven males) who had bone tumors that were treated with en bloc resection and distraction osteogenesis between 1991 - 2000. Materials and methods The average age of the patients was 19.3 years ( 14 - 42 years). The histological diagnosis was osteosarcoma in four cases, Ewing's sarcoma in two, giant cell tumor in one, osteofibrous dysplasia in one and osteoblastoma in one. A uniplanar external fixator was applied to one case and circular external fixator to the other eight cases. Results The average follow-up period was 59.1 months ( 27 - 129 months). The external fixator was removed at an average of 18.1 months ( range, 4 19 months). The average bone defect after resection was 14 cm ( 8 - 24 cm) and the average external fixation index, distraction index, and maturation index were 31.5 ( 18.7 - 40.0), 11.2 ( 10.9 - 11.2) and 17.8 ( 7.5 - 32.7), respectively. The function of the affected leg was excellent in four patients, good in three, fair in one and poor in one according to the Enneking scoring system. We did not observe any early consolidation or osseous binding in the defect area in any patient. Frequent complications were pin tract infection and non-union at the docking site. Conclusion Our results indicate that the Ilizarov method allows effective restoration of bone defects in the treatment of bone tumors despite various disadvantages.