From January 2000 to January 2010, 65 patients [37 males, 28 females; (17.0±6.5) years] suffering from the proximal tibial
osteosarcoma had a
limb-salvage operation. According to the Enneking staging system, 35 patients were in stage IIa, 30 in stage IIb. All of the patients underwent resection of the
osteosarcomas and reconstruction of the bone defect by prothesis. Among them, there were 35 patients underwent the medial head of the gastrocnemius muscle flap transposition to reconstruct the soft tissues and the other 30 didn't.
RESULTS: All the patients were followed-up. In the group with the transposition of medial gastrocnemius muscle flap, the length of
tumor bone resection was (13.5±4.2) cm, operation time was (150±45) min, intraoperative blood loss was (700±135) mL, and drainage volume was (500±200) mL. In the group without the transposition of medial gastrocnemius muscle flap, the length of
tumor bone resection was (12.3±5.8) cm, operation time was (135±37) min, intraoperative blood loss was (600±105) mL, and drainage volume was (450±250) mL. There was significant difference in the operation time (P<0.05) but no significant difference in the intraoperative blood loss and drainage volume (P>0.05). In the group with the transposition of medial gastrocnemius muscle flap, local skin
necrosis occurred in 2 patients (5.7%), and
prosthesis deep
infection occurred in 1 (2.9%). In the group without the transposition of medial gastrocnemius muscle flap, subctaneous
hematocele, and effusion occurred in 3 (10.0%),
wound infection occurred in 4 (13.3%), 1 cured and the other 3 developed
prosthesis deep
infection.There was significant difference in the rate of local complications (P<0.05). According to the function assessment by the Enneking system, in the group with the transposition of medial gastrocnemius muscle flap, 13 patients had excellent results, 17 had good results, 3 had fair results and 2 had poor results, with a satisfaction rate of 85.7%. In the group without the transposition of medial gastrocnemius muscle flap, 10 patients had excellent results, 12 had good results, 5 had fair results and 3 had poor results, with a satisfaction rate of 73.3%. There was significant difference in function assessment between the 2 groups (P<0.05).
CONCLUSION: