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Mid-term complication rate after limb salvage for pediatric bone sarcomas
Michael J Colello1,2, Abigail Padilla2, Annika Y Myers2
1Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, South Carolina.
Journal of Pediatric Orthopedics. Part B
|June 5, 2026
Summary
Limb salvage surgery for pediatric bone sarcomas has a high complication rate, with 75% of patients experiencing issues. Surgeons must be prepared for frequent complications and reoperations in these young cancer patients.
Area of Science:
- Pediatric Orthopedic Oncology
- Surgical Reconstruction
- Oncology
Background:
- Limb salvage surgery is crucial for treating pediatric bone sarcomas.
- Understanding mid-term complications is vital for patient management.
Purpose of the Study:
- To detail the mid-term complication profile following limb salvage for pediatric bone sarcomas.
- To analyze complications across various reconstruction techniques.
Main Methods:
- Retrospective review of patients under 18 with primary bone sarcoma undergoing limb salvage.
- Stratification by reconstruction type: endoprosthetic, allograft, composite, biologic.
- Analysis of complication rates, types, timing, and reoperation frequency.
Main Results:
- Overall complication rate was 75%, with 36% major complications in 84 patients (median follow-up 46 months).
- 55% required reoperation, with 14% needing three or more.
- 71% experienced their first complication within 1 year; 28% had early reoperation within 12 weeks.
Conclusions:
- Limb salvage for pediatric bone sarcomas involves high complication and reoperation rates irrespective of technique.
- These procedures are integral to multidisciplinary care, necessitating preparedness for complications, especially during chemotherapy.
- Provides realistic expectations for postoperative outcomes in pediatric limb salvage patients.