抄録
Limb salvage procedure has been accepted with the progress of chemotherapy. On the other hand there is a problem of leg length discrepancy in the reconstruction of the lower extremity in younger children.
The authors treated two children with osteosarcoma by reconstruction with extendable endoprosthesis. The patients were 12 and 10 years old at operation, and stage III B and stage II B respectively. Follow-up period were 5 and 8 months. Howmedica Growing Kotz System was used as the extendable implants. When seen for follow-up, functional evaluation showed 47% and 30%, and leg length discrepancy became 4cm and 1cm. In the first case 2.5cm of elongation procedure was performed after 5 months.
This systematic prosthesis can be elongated easily with the use of two screw devices via small skin incisions. According to Kotz et al, the length of elongation at one time should be within 1.5cm because of the complication of transient peroneal palsy. Shiller et al reported that the mean length of the total elongation gained of 6 patients who reached skeletal maturity was 13.15cm requiring 53 planned procedures.
In growing limbs in which the eventual shortening can be predicted, extendable endoprosthesis is useful as the reconstruction of the defects after resection of malignant bone tumor.
