The accuracy of free hand resection in limb salvage surgery of bone tumours.

PURPOSE

Resection length should be designed before limb salvage surgery of bone tumours. The aim of this study was to evaluate the accuracy of free hand resections.

METHODS

Two hundred forty-eight cases were enrolled, including 173 osteosarcomas, 24 giant cell tumours, 16 chondrosarcomas, seven spindle cell sarcomas, 14 bone metastases, three undifferentiated pleomorphic sarcomas, three Ewing sarcomas, two angiosarcomas, and six other bone and soft tissue tumours. One hundred forty-six were located in the femur, 75 in the tibia, 19 in the humerus, six in the radius, one in the ulna, and one in the fibula. The resection length was included in the pre-operative plan. After surgery, we measure the length of specimens. Both lengths were compared. The patients were classified by tumour location.

RESULTS

The range of length difference was from - 21 to 29 mm. The mean absolute value of the differences was 8.0 ± 6.3 mm. Altogether, 173 cases (69.8%) had an absolute difference value of ≤ 10 mm, 66 cases (26.6%) of 10-20 mm, and only 9 cases (3.6%) of > 20 mm. The average length of gross specimens (164.1 ± 43.3 mm) was longer than planned lengths (160.7 ± 44.2 mm); p < 0.001.

CONCLUSIONS

The differences were significant in the distal femur and proximal tibia. Even though, the accuracy of free hand resection is acceptable in this method.