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Rotationplasty in the elderly.

Hardes J, Exner GU, Rosenbaum D, Streitbuerger A, Gebert C, Gosheger G, Ahrens H - Sarcoma (2008)

Bottom Line: Discussion.Our study demonstrates that rotationplasty is an alternative to an above-knee amputation in older patients but with poorer functional results in comparison to younger patients.However, limb-salvage surgery should be preferred whenever possible.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Westfälische Wilhelms University Münster, Albert Schweitzer strasse 33, 48149 Münster, Germany.

ABSTRACT
Purpose. Rotationplasty has proven its efficacy in the treatment of malignant bone tumors of the lower extremity in predominantly young patients. To our knowledge this procedure has not been reported in patients over 60 years before. Materials and Methods. 3 patients over 60 years with an A1-rotationplasty because of a sarcoma were included in this study. Complications and functional results were recorded. In one patient an electromyography was done. Results. Despite electromyography showing good adaptation of the muscles to the altered function, the functional results of these three patients were limited. two out of three patients needed a cane for walking distances over 200 meters. No secondary amputation was necessary. Discussion. Our study demonstrates that rotationplasty is an alternative to an above-knee amputation in older patients but with poorer functional results in comparison to younger patients. However, limb-salvage surgery should be preferred whenever possible.

No MeSH data available.


Related in: MedlinePlus

Photographs 6 months postoperatively showing an unrestricted dorsalextension and plantarflexion of the ankle.
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fig4: Photographs 6 months postoperatively showing an unrestricted dorsalextension and plantarflexion of the ankle.

Mentions: Two patients needed a cane fora gait distance of more than 200 meters. The walking distance even with supportwas reduced but ranged from 500 to 2000 meters. However, no patient experiencedpain and needed analgesics. The range of motion of the ankle joint was notrestricted (Figure 4). In patient number 2 no signs of degenerative jointdisease of the ankle joint could be observed 15 years postoperatively. However,osteopenia due to the limited loading of the rotated leg was obvious (Figures 5(a) and 5(b)). The mean Enneking score was 19 of 30 points. All patients wereamenable to having the same surgery again if necessary.


Rotationplasty in the elderly.

Hardes J, Exner GU, Rosenbaum D, Streitbuerger A, Gebert C, Gosheger G, Ahrens H - Sarcoma (2008)

Photographs 6 months postoperatively showing an unrestricted dorsalextension and plantarflexion of the ankle.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2494588&req=5

fig4: Photographs 6 months postoperatively showing an unrestricted dorsalextension and plantarflexion of the ankle.
Mentions: Two patients needed a cane fora gait distance of more than 200 meters. The walking distance even with supportwas reduced but ranged from 500 to 2000 meters. However, no patient experiencedpain and needed analgesics. The range of motion of the ankle joint was notrestricted (Figure 4). In patient number 2 no signs of degenerative jointdisease of the ankle joint could be observed 15 years postoperatively. However,osteopenia due to the limited loading of the rotated leg was obvious (Figures 5(a) and 5(b)). The mean Enneking score was 19 of 30 points. All patients wereamenable to having the same surgery again if necessary.

Bottom Line: Discussion.Our study demonstrates that rotationplasty is an alternative to an above-knee amputation in older patients but with poorer functional results in comparison to younger patients.However, limb-salvage surgery should be preferred whenever possible.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Westfälische Wilhelms University Münster, Albert Schweitzer strasse 33, 48149 Münster, Germany.

ABSTRACT
Purpose. Rotationplasty has proven its efficacy in the treatment of malignant bone tumors of the lower extremity in predominantly young patients. To our knowledge this procedure has not been reported in patients over 60 years before. Materials and Methods. 3 patients over 60 years with an A1-rotationplasty because of a sarcoma were included in this study. Complications and functional results were recorded. In one patient an electromyography was done. Results. Despite electromyography showing good adaptation of the muscles to the altered function, the functional results of these three patients were limited. two out of three patients needed a cane for walking distances over 200 meters. No secondary amputation was necessary. Discussion. Our study demonstrates that rotationplasty is an alternative to an above-knee amputation in older patients but with poorer functional results in comparison to younger patients. However, limb-salvage surgery should be preferred whenever possible.

No MeSH data available.


Related in: MedlinePlus