Major neurovascular involvementspecifically the popliteal vessels. A fracture through a bone affected by a tumor spreads tumor cells via the hematoma beyond accurately determined limits. The risk of local recurrence increases following a pathologic fracture, making resection inadvisable. Inappropriate biopsy sites. An inappropriate or poorly planned biopsy jeopardizes local tumor control by contaminating normal tissue planes and compartments.
Sepsis jeopardizes the effectiveness of adjuvant chemotherapy.
Immature skeletal age. Upperextremity reconstruction is independent of skeletal maturity. An expandable prosthesis or a rotation plasty can be utilized in the young child.13,14 6. Extensive muscle involvement. Enough muscle must remain to reconstruct a functional extremity.