Prinzipien der Defektrekonstruktion nach weiter Resektion primärer maligner Knochentumoren des Fersenbeins
(2023) Fuß & Sprunggelenk — Vol. 21, n° 1, p. 3-26 (2023)
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- (en) [Principles of defect reconstruction after wide resection of primary malignant bone tumours of the calcaneus] Primary malignant bone tumors are a rare and heterogeneous group of malignancies. The most common tumor entities of bone sarcomas are osteosarcoma, chondrosarcoma, and ewing's sarcoma; with talus and calcaneus, the hindfoot represents the most common localization affected. Surgical resection is the mainstay of treatment for localized bone tumor, with various techniques available depending on the histologic type, grading, and location of the tumor. In poorly differentiated bone sarcomas (≥ G2), wide resection is essential to successfully treat the tumor disease locally as well as systemically. Reconstruction of the resulting defect situations poses a challenge to the treating surgeon due to the rarity of the disease, heterogeneity of tumor involvement, and individual patient factors. While proven therapeutic concepts exist for reconstruction after resection of bone sarcomas of the most common localisations (distal femur, proximal tibia, proximal humerus) e.g. with modular megaprosthesis or rotationplasty, these seem to be less established for the foot and ankle. Reconstructive procedures after calcanectomy are manifold, but due to their rarity, they are mostly published as case reports. In principle, defect reconstruction can be divided into biological (autologous or allogenic) and alloarthroplastic procedures. Moreover, we will discuss the option of a resectionarthroplasty after partial or total calcanectomy with transposition of the Achilles tendon. This article aims to present the principles of calcaneal defect reconstruction after extensive tumor resection based on a literature review and to highlight possible problems of different types of reconstruction with exemplary case reports.
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Marino Farei-Campagna, J., Toepfer, A., Potocnik, P., & Schubert, T. (2023). Prinzipien der Defektrekonstruktion nach weiter Resektion primärer maligner Knochentumoren des Fersenbeins. Fuß & Sprunggelenk, 21(1), 3-26. https://doi.org/10.1016/j.fuspru.2023.02.002 (Original work published 2023)