Reconstruction of massive tibial defects after resection of adamantinoma with double-level distraction osteogenesis

Adamantinoma is an extremely rare disease that typically involves large portions of the tibial cortex requiring extensive resections, for which a myriad of complex reconstructions have been performed with varying success. Techniques of bone regeneration utilizing internal or external methods are use...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Eugenia Schwarzkopf [verfasserIn] Molly Friel Klima [verfasserIn] Abraham Trabulsy [verfasserIn] Daniel Eduardo Prince [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2019

Schlagwörter:	damantinoma distraction osteogenesis double level bone transport osteofibrous dysplasia osteofibrous dysplasia-like adamantinoma

Übergeordnetes Werk:	In: Journal of Limb Lengthening & Reconstruction - Wolters Kluwer Medknow Publications, 2018, 5(2019), 1, Seite 41-46
Übergeordnetes Werk:	volume:5 ; year:2019 ; number:1 ; pages:41-46

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.4103/jllr.jllr_13_19

Katalog-ID:	DOAJ050306421

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520			\|a Adamantinoma is an extremely rare disease that typically involves large portions of the tibial cortex requiring extensive resections, for which a myriad of complex reconstructions have been performed with varying success. Techniques of bone regeneration utilizing internal or external methods are used to manage bone defects in trauma, infection and congenital deformities, but less commonly used for oncological osseous defects. We present four cases of patients diagnosed between 2015 – 2018 with tibial adamantinoma in a background of osteofibrous dysplasia who underwent distraction osteogenesis reconstruction via a double level cable bone transport. In all cases wide resection of the adamantinoma was performed to achieve negative surgical margins and the defect reconstructed by double level bone transport using Ilizarov cables guiding distraction osteogenesis. Bone transport occurred at a combined mean rate of 2 mm per day: 1mm proximally and 1mm distally. Full weight-bearing and ambulation were encouraged immediately. The mean age at time of surgery was 18 years (14 – 25) and the mean size of tibial defect was 23 cm (17.5 – 26). The mean time in external fixation was 8.5 months (6 – 12 months), yielding a mean External-Fixation Index (EFI) of 0.44 month/cm (0.3 – 0.69). The average MSTS score at mean follow time of 20 months (13-27 months) is 28 (26 – 30). At last follow up all patients are infection free and without evidence of disease. Despite typical complications of prolonged external fixation, all four patients have excellent results with an average MSTS score of 28. The mean EFI of 0.44 month/cm is well below the standard EFI of 1 month/cm, suggesting this subset of patients may require less external fixation time than previously considered. The case series supports the hypothesis that double level D.
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spelling	10.4103/jllr.jllr_13_19 doi (DE-627)DOAJ050306421 (DE-599)DOAJ2da165fca35f4e34984fd4297ded0b16 DE-627 ger DE-627 rakwb eng RD701-811 Eugenia Schwarzkopf verfasserin aut Reconstruction of massive tibial defects after resection of adamantinoma with double-level distraction osteogenesis 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Adamantinoma is an extremely rare disease that typically involves large portions of the tibial cortex requiring extensive resections, for which a myriad of complex reconstructions have been performed with varying success. Techniques of bone regeneration utilizing internal or external methods are used to manage bone defects in trauma, infection and congenital deformities, but less commonly used for oncological osseous defects. We present four cases of patients diagnosed between 2015 – 2018 with tibial adamantinoma in a background of osteofibrous dysplasia who underwent distraction osteogenesis reconstruction via a double level cable bone transport. In all cases wide resection of the adamantinoma was performed to achieve negative surgical margins and the defect reconstructed by double level bone transport using Ilizarov cables guiding distraction osteogenesis. Bone transport occurred at a combined mean rate of 2 mm per day: 1mm proximally and 1mm distally. Full weight-bearing and ambulation were encouraged immediately. The mean age at time of surgery was 18 years (14 – 25) and the mean size of tibial defect was 23 cm (17.5 – 26). The mean time in external fixation was 8.5 months (6 – 12 months), yielding a mean External-Fixation Index (EFI) of 0.44 month/cm (0.3 – 0.69). The average MSTS score at mean follow time of 20 months (13-27 months) is 28 (26 – 30). At last follow up all patients are infection free and without evidence of disease. Despite typical complications of prolonged external fixation, all four patients have excellent results with an average MSTS score of 28. The mean EFI of 0.44 month/cm is well below the standard EFI of 1 month/cm, suggesting this subset of patients may require less external fixation time than previously considered. The case series supports the hypothesis that double level D. damantinoma distraction osteogenesis double level bone transport osteofibrous dysplasia osteofibrous dysplasia-like adamantinoma Orthopedic surgery Molly Friel Klima verfasserin aut Abraham Trabulsy verfasserin aut Daniel Eduardo Prince verfasserin aut In Journal of Limb Lengthening & Reconstruction Wolters Kluwer Medknow Publications, 2018 5(2019), 1, Seite 41-46 (DE-627)1736211099 24553719 nnns volume:5 year:2019 number:1 pages:41-46 https://doi.org/10.4103/jllr.jllr_13_19 kostenfrei https://doaj.org/article/2da165fca35f4e34984fd4297ded0b16 kostenfrei http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2019;volume=5;issue=1;spage=41;epage=46;aulast=Schwarzkopf kostenfrei https://doaj.org/toc/2455-3719 Journal toc kostenfrei https://doaj.org/toc/2455-3719 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2019 1 41-46
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allfieldsSound	10.4103/jllr.jllr_13_19 doi (DE-627)DOAJ050306421 (DE-599)DOAJ2da165fca35f4e34984fd4297ded0b16 DE-627 ger DE-627 rakwb eng RD701-811 Eugenia Schwarzkopf verfasserin aut Reconstruction of massive tibial defects after resection of adamantinoma with double-level distraction osteogenesis 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Adamantinoma is an extremely rare disease that typically involves large portions of the tibial cortex requiring extensive resections, for which a myriad of complex reconstructions have been performed with varying success. Techniques of bone regeneration utilizing internal or external methods are used to manage bone defects in trauma, infection and congenital deformities, but less commonly used for oncological osseous defects. We present four cases of patients diagnosed between 2015 – 2018 with tibial adamantinoma in a background of osteofibrous dysplasia who underwent distraction osteogenesis reconstruction via a double level cable bone transport. In all cases wide resection of the adamantinoma was performed to achieve negative surgical margins and the defect reconstructed by double level bone transport using Ilizarov cables guiding distraction osteogenesis. Bone transport occurred at a combined mean rate of 2 mm per day: 1mm proximally and 1mm distally. Full weight-bearing and ambulation were encouraged immediately. The mean age at time of surgery was 18 years (14 – 25) and the mean size of tibial defect was 23 cm (17.5 – 26). The mean time in external fixation was 8.5 months (6 – 12 months), yielding a mean External-Fixation Index (EFI) of 0.44 month/cm (0.3 – 0.69). The average MSTS score at mean follow time of 20 months (13-27 months) is 28 (26 – 30). At last follow up all patients are infection free and without evidence of disease. Despite typical complications of prolonged external fixation, all four patients have excellent results with an average MSTS score of 28. The mean EFI of 0.44 month/cm is well below the standard EFI of 1 month/cm, suggesting this subset of patients may require less external fixation time than previously considered. The case series supports the hypothesis that double level D. damantinoma distraction osteogenesis double level bone transport osteofibrous dysplasia osteofibrous dysplasia-like adamantinoma Orthopedic surgery Molly Friel Klima verfasserin aut Abraham Trabulsy verfasserin aut Daniel Eduardo Prince verfasserin aut In Journal of Limb Lengthening & Reconstruction Wolters Kluwer Medknow Publications, 2018 5(2019), 1, Seite 41-46 (DE-627)1736211099 24553719 nnns volume:5 year:2019 number:1 pages:41-46 https://doi.org/10.4103/jllr.jllr_13_19 kostenfrei https://doaj.org/article/2da165fca35f4e34984fd4297ded0b16 kostenfrei http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2019;volume=5;issue=1;spage=41;epage=46;aulast=Schwarzkopf kostenfrei https://doaj.org/toc/2455-3719 Journal toc kostenfrei https://doaj.org/toc/2455-3719 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2019 1 41-46
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spellingShingle	Eugenia Schwarzkopf misc RD701-811 misc damantinoma misc distraction osteogenesis misc double level bone transport misc osteofibrous dysplasia misc osteofibrous dysplasia-like adamantinoma misc Orthopedic surgery Reconstruction of massive tibial defects after resection of adamantinoma with double-level distraction osteogenesis
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topic_title	RD701-811 Reconstruction of massive tibial defects after resection of adamantinoma with double-level distraction osteogenesis damantinoma distraction osteogenesis double level bone transport osteofibrous dysplasia osteofibrous dysplasia-like adamantinoma
topic	misc RD701-811 misc damantinoma misc distraction osteogenesis misc double level bone transport misc osteofibrous dysplasia misc osteofibrous dysplasia-like adamantinoma misc Orthopedic surgery
topic_unstemmed	misc RD701-811 misc damantinoma misc distraction osteogenesis misc double level bone transport misc osteofibrous dysplasia misc osteofibrous dysplasia-like adamantinoma misc Orthopedic surgery
topic_browse	misc RD701-811 misc damantinoma misc distraction osteogenesis misc double level bone transport misc osteofibrous dysplasia misc osteofibrous dysplasia-like adamantinoma misc Orthopedic surgery
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title	Reconstruction of massive tibial defects after resection of adamantinoma with double-level distraction osteogenesis
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title_full	Reconstruction of massive tibial defects after resection of adamantinoma with double-level distraction osteogenesis
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title_sort	reconstruction of massive tibial defects after resection of adamantinoma with double-level distraction osteogenesis
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title_auth	Reconstruction of massive tibial defects after resection of adamantinoma with double-level distraction osteogenesis
abstract	Adamantinoma is an extremely rare disease that typically involves large portions of the tibial cortex requiring extensive resections, for which a myriad of complex reconstructions have been performed with varying success. Techniques of bone regeneration utilizing internal or external methods are used to manage bone defects in trauma, infection and congenital deformities, but less commonly used for oncological osseous defects. We present four cases of patients diagnosed between 2015 – 2018 with tibial adamantinoma in a background of osteofibrous dysplasia who underwent distraction osteogenesis reconstruction via a double level cable bone transport. In all cases wide resection of the adamantinoma was performed to achieve negative surgical margins and the defect reconstructed by double level bone transport using Ilizarov cables guiding distraction osteogenesis. Bone transport occurred at a combined mean rate of 2 mm per day: 1mm proximally and 1mm distally. Full weight-bearing and ambulation were encouraged immediately. The mean age at time of surgery was 18 years (14 – 25) and the mean size of tibial defect was 23 cm (17.5 – 26). The mean time in external fixation was 8.5 months (6 – 12 months), yielding a mean External-Fixation Index (EFI) of 0.44 month/cm (0.3 – 0.69). The average MSTS score at mean follow time of 20 months (13-27 months) is 28 (26 – 30). At last follow up all patients are infection free and without evidence of disease. Despite typical complications of prolonged external fixation, all four patients have excellent results with an average MSTS score of 28. The mean EFI of 0.44 month/cm is well below the standard EFI of 1 month/cm, suggesting this subset of patients may require less external fixation time than previously considered. The case series supports the hypothesis that double level D.
abstractGer	Adamantinoma is an extremely rare disease that typically involves large portions of the tibial cortex requiring extensive resections, for which a myriad of complex reconstructions have been performed with varying success. Techniques of bone regeneration utilizing internal or external methods are used to manage bone defects in trauma, infection and congenital deformities, but less commonly used for oncological osseous defects. We present four cases of patients diagnosed between 2015 – 2018 with tibial adamantinoma in a background of osteofibrous dysplasia who underwent distraction osteogenesis reconstruction via a double level cable bone transport. In all cases wide resection of the adamantinoma was performed to achieve negative surgical margins and the defect reconstructed by double level bone transport using Ilizarov cables guiding distraction osteogenesis. Bone transport occurred at a combined mean rate of 2 mm per day: 1mm proximally and 1mm distally. Full weight-bearing and ambulation were encouraged immediately. The mean age at time of surgery was 18 years (14 – 25) and the mean size of tibial defect was 23 cm (17.5 – 26). The mean time in external fixation was 8.5 months (6 – 12 months), yielding a mean External-Fixation Index (EFI) of 0.44 month/cm (0.3 – 0.69). The average MSTS score at mean follow time of 20 months (13-27 months) is 28 (26 – 30). At last follow up all patients are infection free and without evidence of disease. Despite typical complications of prolonged external fixation, all four patients have excellent results with an average MSTS score of 28. The mean EFI of 0.44 month/cm is well below the standard EFI of 1 month/cm, suggesting this subset of patients may require less external fixation time than previously considered. The case series supports the hypothesis that double level D.
abstract_unstemmed	Adamantinoma is an extremely rare disease that typically involves large portions of the tibial cortex requiring extensive resections, for which a myriad of complex reconstructions have been performed with varying success. Techniques of bone regeneration utilizing internal or external methods are used to manage bone defects in trauma, infection and congenital deformities, but less commonly used for oncological osseous defects. We present four cases of patients diagnosed between 2015 – 2018 with tibial adamantinoma in a background of osteofibrous dysplasia who underwent distraction osteogenesis reconstruction via a double level cable bone transport. In all cases wide resection of the adamantinoma was performed to achieve negative surgical margins and the defect reconstructed by double level bone transport using Ilizarov cables guiding distraction osteogenesis. Bone transport occurred at a combined mean rate of 2 mm per day: 1mm proximally and 1mm distally. Full weight-bearing and ambulation were encouraged immediately. The mean age at time of surgery was 18 years (14 – 25) and the mean size of tibial defect was 23 cm (17.5 – 26). The mean time in external fixation was 8.5 months (6 – 12 months), yielding a mean External-Fixation Index (EFI) of 0.44 month/cm (0.3 – 0.69). The average MSTS score at mean follow time of 20 months (13-27 months) is 28 (26 – 30). At last follow up all patients are infection free and without evidence of disease. Despite typical complications of prolonged external fixation, all four patients have excellent results with an average MSTS score of 28. The mean EFI of 0.44 month/cm is well below the standard EFI of 1 month/cm, suggesting this subset of patients may require less external fixation time than previously considered. The case series supports the hypothesis that double level D.
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title_short	Reconstruction of massive tibial defects after resection of adamantinoma with double-level distraction osteogenesis
url	https://doi.org/10.4103/jllr.jllr_13_19 https://doaj.org/article/2da165fca35f4e34984fd4297ded0b16 http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2019;volume=5;issue=1;spage=41;epage=46;aulast=Schwarzkopf https://doaj.org/toc/2455-3719
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The mean time in external fixation was 8.5 months (6 – 12 months), yielding a mean External-Fixation Index (EFI) of 0.44 month/cm (0.3 – 0.69). The average MSTS score at mean follow time of 20 months (13-27 months) is 28 (26 – 30). At last follow up all patients are infection free and without evidence of disease. Despite typical complications of prolonged external fixation, all four patients have excellent results with an average MSTS score of 28. The mean EFI of 0.44 month/cm is well below the standard EFI of 1 month/cm, suggesting this subset of patients may require less external fixation time than previously considered. 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code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Daniel Eduardo Prince</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">In</subfield><subfield code="t">Journal of Limb Lengthening & Reconstruction</subfield><subfield code="d">Wolters Kluwer Medknow Publications, 2018</subfield><subfield code="g">5(2019), 1, Seite 41-46</subfield><subfield code="w">(DE-627)1736211099</subfield><subfield code="x">24553719</subfield><subfield code="7">nnns</subfield></datafield><datafield tag="773" ind1="1" ind2="8"><subfield code="g">volume:5</subfield><subfield code="g">year:2019</subfield><subfield code="g">number:1</subfield><subfield code="g">pages:41-46</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doi.org/10.4103/jllr.jllr_13_19</subfield><subfield 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Reconstruction of massive tibial defects after resection of adamantinoma with double-level distraction osteogenesis

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