Abstract:
Introduction: Osteosarcoma is the most common primary malignant
bone tumor affects the limbs. Osteosarcomas are most commonly located in
the metaphysis of long bones, especially around the knee in the distal
femur or proximal tibia. Osteosarcoma is managed by neoadjuvant
chemotherapy, surgery and adjuvant chemotherapy. There are 2 types of
surgery: limb salvage and amputation. The location and size of the
tumour, extra‐medullary extension, existence of metastasis, preliminary
tumour necrosis, age and skeletal development are the selection criteria
for the type of surgery. Limb-salvage surgery refers to the surgical
procedure to restore bone and joint function after extensive resection
of malignant bone tumors of the limbs. Nowadays, Limb salvage with
neoadjuvant chemotherapy is the preferred option for osteosarcoma
management by most surgeons.
Case presentation: a 19 years male present to the orthopaedic
clinic complaining of pain and fungating swelling with offensive odor
for six months in his left proximal tibia. On physical examination knee
movement was restricted. Biopsy was obtained and revealed patient had
osteosarcoma. Patient underwent neoadjuvant chemotherapy and limb
salvage surgery.
Clinical discussion: limb salvage surgery was good option to
maintain patient limb, to improve patient quality of life, maintain
psychological status of the patient and had higher 5-year survival rate
more than amputation. Limb salvage surgery also maintains the function
of the limb.
Conclusion: limb salvage surgery was better than amputation in
preservation of limb function, psychological status and quality of live.
Not any fungating tumor for amputation.