Replacement of extensive bone defects in patients with locomotor system tumors

The paper discusses the problem in replacing extensive bone defects after adequate resections in patients with locomotor system tumors, defines a concept of an adequate operation, and provides an original classification of osteotumors by the extent of a tumorous process. After extirpation of the clavicle (including resection of the manubrium sterni and the first rib), scapulectomy, inter-scapulothoracic, pelvic, and proximal fibular resections, the author does not replace bone defects, without deteriorating the surgical functional outcomes. In 135 patients, defects were replaced by variously designed endoprostheses (in 23 of them this was done after total removal of the femur or humerus). Postendoprosthetic complications developed in 14 patients: early suppuration (n = 3), metallosis and late suppuration (n = 3), endoprosthetic fracture (n = 5), and intraoperative bone fracture (n = 3). Bone fracture occurred while mastering the procedure and failed to affect therapeutical functional results. In extensive long bone diaphysial defects and combined bone and soft tissue defects, the author used autografting on micro-vascular anastomoses in 34 patients or defect replacement in the Ilizarov apparatus in 8 patients.