[New surgical procedures in musculoskeletal sarcomas of the child]

The role of surgery remains central in the management of malignant bone tumors in children and adolescents. The current chemotherapies have demonstrated their efficiency (and limits) and made possible to avoid amputation in more than 90% of cases without worsening the prognosis. Advances in imaging (MRI) and understanding the mechanisms of tumor progression have led to more accurate resections with more frequent epiphyseal conservations. At the same time, new techniques have emerged that allows to consider more "organic" reconstructions. Therefore, we can better and more often preserve growth, hoping for a better long-term functional outcome. Experience also allows to review older techniques (arthroplasties…). The choice of reconstruction depends on many factors (age, presence of secondary localizations, chemotherapy tolerance, socioeconomic context…) and can only be conceived as part of multidisciplinary evaluations.