[Preservation of the limbs in osteosarcoma and other primary tumors of bone].

Resection of primary malignant bone tumours, followed by reconstruction and functional preservation of the limbs, seems to give oncological results that are at least equivalent to those of radical amputation surgery. The psychological and functional benefits are obvious: 30% of the patients operated upon recover with a very satisfactory function and resume professional activities or even games; 60% revert to their previous familial and social activities, and 10% only remain severely handicapped. However, numerous problems still have to be solved: the value of this conservative surgery must be demonstrated statistically; the incidence of its complications, notably in the knee, must be reduced; the fate of homografts must be known; its indications must be extended by improving its results in areas where these are still uncertain (e.g. pelvis, lower end of the leg) or functionally mediocre (shoulder). Only comparisons within study groups, either national (such as the PETAL group), or international (such as the Muscule Skelatal Tumor Society), can provide positive answers in a field where question marks are more frequent than certainties.