Treatment of osteosarcomata of the distal femur by rotation-plasty.

Rotation-plasty was carried out on fifteen patients--10 male and 5 female patients aged between 6 and 32--with an osteosarcoma of the distal femur following resection of the tumor. In the operation the lower leg was rotated through 180 degrees after resection of the distal femur and knee joint so that the ankle joint was effectively turned into a "knee joint". The indication for this operation was initially limited to children for whom the only possible therapeutic alternative was a high above-knee amputation. The surprisingly good functional rehabilitation justifies the indication of this method as an alternative to an endoprosthesis or arthrodesis even for young adults. In spite of the cosmetically very unusual position of the foot, none of the patients has so far experienced psychological problems thanks to suitable guidance. Both from an oncological and psychological point of view, this method represents an extremely responsible operation and should therefore only be carried out by hospital departments specializing in the therapy of bone tumors.