The Results of Hemicortical Resection for Malignant Bone Tumor / 대한정형외과학회잡지

ABSTRACT

PURPOSE: Hemicortical resection may be applied to bone tumors arising at the bone surface or of eccentric location due to minimal medullary involvement. The purpose of this study was to evaluate the results of hemicortical resection for malignant bone tumors. MATERIALS AND METHODS: We retrospectively reviewed 18 patients who were treated with hemicortical resection between 2005 and 2014. The study included 10 patients with parosteal osteosarcoma, 5 patients with osteosarcoma, 2 patients with periosteal chondrosarcoma, and 1 patient with chondrosarcoma, who were followed-up for a mean duration of 61 months (24–125 months). We evaluated 1) the oncologic outcome (recurrence, metastasis), 2) the rate of bony union, and 3) complications, such as fracture or infection, after hemicortical resection and reconstruction. RESULTS: There were local recurrences in 3 parosteal osteosarcoma patients (16.7%). After subsequent re-excision for recurrence, one patient died of metastasis. The defect after hemicortical resection was reconstructed by bone graft in 15 patients and the grafts were removed for infection in 2 patients. Bone grafts were united in 12 (92.3%) out of 13 patients at 8 months (5–13 months) after reconstruction on average. Host bone fractures occurred in 2 patients (11.1%); infection developed in 3 patients (16.7%), who received hemicondylar resection for osteosarcoma in proximal tibia. CONCLUSION: Hemicortical resection for eccentric tumors or small tumors showed good clinical results. There is relatively a high risk of infection in the lesion of proximal tibia.