Resumen

LIMA, Sara et al. Cirurgia de salvamento de membro no tratamento de sarcomas ósseos em idade pediátrica: Será uma alternativa segura e eficaz à amputação?. Rev. Port. Ortop. Traum. [online]. 2013, vol.21, n.1, pp.37-43. ISSN 1646-2122.

In the last 30 years, there has been an improvement in the survival rate of patients with sarcomas and in the salvage of limbs, and today most patients are offered limb-salvage surgery. There are a number of options for skeletal reconstruction after bone tumor resection, such as bone transport with distraction osteogenesis. The authors describe two cases in which there was local control of the disease by extensive resection of tumors after a satisfactory response to neoadjuvant chemotherapy, and reconstruction of the defect by bone transport using a monolateral external fixator. The occurrence of complications compromised the evolution. However, the result after 6 years is very encouraging, with complete range of movement of the affected limbs and return to normal activities being achieved in both cases. Currently limb sparing surgery is indicated in cases where it is possible to have extended resection margins without compromising the functionality of the limb. Studies comparing amputation with wide resection of the tumor have obtained similar results concerning the long-term survival. Distraction osteogenesis can successfully regenerate bone for reconstruction of extensive defects after the excision of sarcomas in children, without affecting long-time survival and quality-of-life. The critical point is the duration of treatment and all efforts should be done to shorten it so that the treatment becomes more appealing.

Palabras clave : Limb-salvage procedures; bone transport; distraction osteogenesis; bone sarcomas; pediatric.

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