Clinical effect of surgical resection on primary malignant and invasive bone tumours of the proximal fibula

Pu,Feifei; Yu,Yihan; Zhang,Zhicai; Liu,Jianxiang; Shao,Zengwu; Chen,Fengxia; Feng,Jing

doi:10.3892/mco.2023.2623

Clinical effect of surgical resection on primary malignant and invasive bone tumours of the proximal fibula

Authors:
- Feifei Pu
- Yihan Yu
- Zhicai Zhang
- Jianxiang Liu
- Zengwu Shao
- Fengxia Chen
- Jing Feng
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Affiliations: Department of Orthopaedics, Wuhan Hospital of Traditional Chinese and Western Medicine (Wuhan No. 1 Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China, Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China, Department of Radiation and Medical Oncology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei 430071, P.R. China, Department of Orthopaedics, Wuhan Hospital of Traditional Chinese and Western Medicine (Wuhan No. 1 Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China
Published online on: February 16, 2023 https://doi.org/10.3892/mco.2023.2623
Article Number: 27
Copyright: © Pu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

There is no unified surgical plan for fibular proximal malignant tumours; therefore, the present study retrospectively analysed the medical records of 19 patients with primary malignant and invasive tumours in the proximal fibula and discussed the postoperative oncological results, complications and postoperative functions of limb salvage surgery. According to pathological classification, there were 10 osteosarcoma cases, 3 chondrosarcoma cases, 2 invasive giant cell osteosarcoma tumour cases, 1 epithelioid sarcoma case, 1 leiomyosarcoma case, 1 fibrosarcoma case and 1 lymphoma case. According to the Enneking instalment, IB stage was found in 2 cases, IIA in 2 cases and IIB in 15 cases. A total of 3 patients underwent Malawer I resection, and 16 patients underwent Malawer II resection. The follow‑up period was 11‑174 months, with an average of 76.58 months. Local recurrence occurred in three patients and distant metastasis in seven patients; 4 patients succumbed and 15 survived. After biceps femoris tendon reconstruction and lateral collateral ligament insertion, 18 patients had good knee stability. The Musculoskeletal Tumour Society scale ranged between 23 and 29 points, with an average of 27.26 points; the Lysholm Knee Score was 65‑84 points, with an average of 83 points. After the resection of proximal fibula primary and invasive tumours, the biceps femoris tendon and lateral collateral ligament insertion point was reconstructed. The data show that this technique can effectively reconstruct stability and restore knee function.

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