جراحة الحفاظ على المفصل في أورام العظام الخبيثة عند الأطفال

الملخص EN

Background and Objective: Bone sarcomas are malignant tumors with historically bad reputation, but knew developments in diagnosis and treatment improves the prognosis and allows for Limb sparing surgery.

The aim of this study is to report the results of surgical treatment with Joint preservation for a series of rare cases and to compare this results with international researches.

Materials and Methods: It is a retrospective study evaluating 14 children (29% male & 71% female) (average age 8.6 years) who have bone sarcomas (7 Osteosarcoma & 7 Ewing’s Sarcoma).

All the children were treated by the same surgeon in Children and Al-Bayrouni University Hospitals between 2005-2015 with Joint sparing surgery and were followed-up for mean period of 6.5 years.

Results: The tumors found in the femur in 7 patients, pelvic in 4, tibia in 2, and humerus in one.

the tumors stages were IIA in 7 patients and IIB in 7 patients, they became after neo-adjuvant chemotherapy IIA in 12 patients (improved in 4 patients with Ewing’s sarcoma and one patient with Osteosarcoma).

Recurrence occurred in 3 patients 21.4%, and caused death for 2 patients 14.3% and amputation for the other one, Survival rate was 85.7%, and complications rate among survival was 33.3%, which was fixation failure with non-union, the final functional assessment with MSTS rate was 75.76%.

Conclusion: Early diagnosis and good response for neo-adjuvant chemotherapy is a primary key to obtain good results in Joint sparing surgery even if we excise a tiny free margin.