The management of limb-length discrepancies in children after treatment of osteosarcoma and Ewing's sarcoma.

Abstract

The authors present 15 cases of discrepancy of the lower limbs > 5 cm, in children in whom the histological diagnosis was Ewing's sarcoma or osteosarcoma, who were treated using polychemotherapy or radiotherapy or both in some cases and limb-salvage surgery. Ten of these patients required compensation for discrepancy by limb lengthening. In three patients, a second lengthening had to be carried out. A shortening of the contralateral femur was performed in two cases, and in another two, a femur-tibia epiphysiodesis was done. The average lengthening achieved was 8.1 cm with a healing index of 41 days/cm. Leg-length discrepancy in the treatment of sarcomas of the musculoskeletal system is an important sequela, especially when treating children. Compensation for this can be obtained by lengthening healthy bone, with a complication rate similar to that of other etiologies. The difference compensated depends on the biological capacity of bone regeneration of the individual and, therefore, is a definitive solution.