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Flashcards in Osteosarcoma Deck (10)
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1

Causes of Death in Children Under 20 yrs

1) Accidents
2) Homicides
3) **Cancer**
4) Suicides

2

Osteosarcoma

Primary malignancy of the bone
Derived from primitive bone forming, mesenchyme

3

Ewings’ Sarcoma

Derived from parasympathetic neural crest cells
“Small round blue cell” – CD99
85% have a t(11;22) EWS/FLI1 gene

4

Most Common sites

Distal Femur
Prox Tibia
Prox Humerus

5

When is an amputation considered?

Limb Saving Surgery (LSS) produces an inadequate margin
LSS produces a functional outcome that is worse than amputation w/ prosthesis
LSS is not able to restore active function
LSS is not able to obtain soft tissue coverage

6

Four questions Limb Salvage vs. Amputation:

Will survival be the same?
Will the immediate and late morbidities be the same?
Will limb salvage improve function?
Will limb salvage have psychosocial (QOL) benefits?

7

Limb salvage early wound healing

Soft tissue necrosis
Deep infection
Artery / Vein / Nerve damage
Venous thrombosis
Delay in chemotherapy

8

Limb salvage late wound healing

Nonunion
Pathologic fracture
Aseptic loosening
Leg length discrepancy
Implant breakage

9

Amputation: early wound healing

Inadequate wound coverage
and healing
Infection
Delay in chemotherapy

10

Amputation: late wound healing

Stump-prostheses problems
Stump pain
Phantom limb pain
Bone overgrowth