Modular endoprostheses for children with malignant bone tumors.

BACKGROUND The treatment of malignant bone tumors in skeletally immature patients is difficult because the required surgery removes the growth plate of one extremity. To date, few techniques for limb salvage have been successful due to complications involving limb expansion and limb-length discrepancy. Newer technology is now available for prosthetic replacements for modular expansion. METHODS The authors review current surgical treatment of malignant bone tumors in children, with emphasis on reconstruction with expandable modular prostheses, and they present their own experience. RESULTS Thirty-seven children with malignant bone tumors underwent primary tumor resection and reconstruction with a modular prosthetic device. Fourteen had subsequent successful expansions with modular prostheses. A new prosthesis, in which lengthening is achieved by an external electromagnetic field rather than an open surgical procedure, is discussed. CONCLUSIONS Limb-preserving surgery in children with malignant bone tumors can be accomplished successfully with modern prosthetic devices that have expandable modules within them. The technique of expandable prostheses using electromagnetic fields rather than surgical interventions shows promise.