Massive allogenic bone grafts in reconstructive surgery after local resection of malignant bone tumor]

A series of 11 patients (5 females, 6 males) aged 11 to 43 years (mean 19.5 years) with primary malignant bone tumor is presented. MRI and CT served to determine the exact tumor invasion within soft tissues and medullar cavity. Prior to the surgery IIB stage (Enneking) was established in all cases. Chemotherapy was used in 7 cases, radiotherapy in 1. Local excision of the tumor was followed by implantation of massive frozen bone graft. Fixation was achieved with intramedullary nails, screws, AO plates or Martin external fixator. Follow-up ranged from 2 years 4 months to 5 years 2 months (mean 3 years 6 months). Adjuvant pre- and post-operative chemotherapy allowed for limb salvage and excision procedure with massive allograft to fill the defect. One patient died due to dissemination of the neoplastic disease, remaining 10 are alive with no symptoms of metastases. Stable osteosynthesis allows for early axial weight bearing and fast rehabilitation of the limb.