Surgical management of malignant bone tumours

Limb-salvage surgery has proved adequate in the management of malignant bone tumours. The goal of radical resection is to achieve local control with an appropriate surgical margin. Sixty-five cases of bone tumours have been managed by radical resection and suitable reconstruction by autologous fibular strut grafting. Single fibular grafting was attempted in the upper extremity and dual fibular grafting in the lower extremity. None had obvious evidence of secondary metastases at the time of surgery. out of 65 cases, 39 were sarcomatous lesions. Biplane Angiography had proved extremely useful in the exact delineation and appropriate resection of such lesions. Twenty two patients had complications - eight had local recurrence, three had deep infection needing amputation and eleven had multiple secondaries and died. It is suggested that in an Oncologically sound limb, salvage procedure with biological reconstruction should be attempted.