[Limb salvage surgery using massive allografts in malignant bone tumors].

The advantages of segmental allografts over arthoplastics are, among others, secured biological healing, easy attachment of tendons and ligaments, and desirable long-tem results. Since 1983, the authors have performed 35 resections of malignant tumors in the extremities followed by reconstructions with implantation of segmental allografts. Five types of grafts were used for the reconstruction of the skeletal defects, intercalary hemicylinder, intercalary cylinder, partial osteoarticular, total osteoarticular, and allograft-prosthetic implant composite. All the patients underwent adjunctive chemotherapy that was considered necessary. The length of follow-up ranged from 6 months to 10 years during which time 6 patients died, 25 were disease-free, and 4 survived as tumors-carriers. Complications in 28.6% of the patients included infection, graft resorption, recurrence and nonunion. Patients undergoing intercalary grafts oblained better functional results than those having osteoarticular grafts. 4 patients had biopsies and bone scans of the grafts 2-4 years postoperation with creeping substituion being observed. Segmental allograft remains a viable approach with predictable results for reconstruction of skeletal defects after resection of malignant bone tumors.