Modified Van Nes rotationplasty for osteosarcoma of the proximal tibia in children.

Above-knee amputation has been the traditional treatment for osteosarcoma of the proximal tibia. Recent advances in chemotherapy have encouraged the development of limb-salvage techniques. Van Nes rotationplasty for malignant lesions of the distal femur has increased in popularity as a reconstructive technique, but no similar procedure has been described for lesions of the proximal tibia. We have developed a modified rotationplasty for this lesion and have performed it in four children. The surgical technique, postoperative management and results of the procedure are described. Two patients had delayed wound healing. No other complications have developed and our patients were disease-free at follow-up, while the appearance of the leg was well accepted by the patients and their parents. This procedure is a useful addition to the armamentarium of the tumour surgeon for the treatment of malignant lesions of the proximal tibia.

Kodiak seamount not flat-topped.

Earlier surveys in the Aleutian Trench southeast of Kodiak Island, Alaska, indicated that Kodiak Seamount had a flat top and was a tablemount or guyot. This seamount is of special significance because it has been supposed that its surface was eroded at the same time as those of a line of guyots to the southeast. If so, its present position in the axis of the Aleutian Trench indicates that the line of guyots was formed before the trench. A two-part survey in 1965 showed that Kodiak Seamount is not flat-topped, and should be eliminated from the category of guyots. Reflection profiling records indicate that the seamount was formed before the adjacent sediments were deposited, and that the small trough, or moat, on the south side is a depositional feature probably formed by a scouring effect or by the acceleration of turbidity currents around the base of the mount.