While resection and reconstruction of the distal radius can be accomplished with an autograft wrist arthrodesis with excellent functional results, knee or elbow arthrodeses are less satisfying. Metal replacement reconstructions have an advantage over allograft procedures in that the limb can allow immediate weight bearing and rehabilitation. Autograft and allograft reconstructions require significant time to allow the osteotomies to unite. Nonunion is a common complication in these patients, specifically in patients who are receiving chemotherapy. Repeat autogenous bone grafting may be necessary.
Late fractures occur in a large percentage of patients with allograft reconstructions.
First, limb length inequality can be avoided in the skeletally immature patient if the physes are not violated, Secondly, a biologic reconstruction that heals after an intercalary resection will leave the patient with the most anatomic limb without concern of prosthetic failure, joint instability, or joint degeneration. Similarly, the function of the limb with normal joints around the reconstruction and only partial muscular resection will have excellent functional potential. Clearly, the functional result after tumor resection is related to the amount of tissue that must be resected, the anatomic location of the tumor and the rehabilitative capacity of the patient. All of these factors must be taken into consideration when a surgical plan is developed. A system of staging musculoslicletal neoplasms.