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.