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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 7, 924-928.
doi: 10.1302/0301-620X.90B7.20674  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Safety of external fixation during postoperative chemotherapy

H. Tsuchiya, MD, PhD, Professor1; T. Shirai, MD, Assistant Professor1; A. F. Morsy, MD, Clinical Fellow1; K. Sakayama, MD, PhD, Lecturer2; T. Wada, MD, PhD, Associate Professor3; K. Kusuzaki, MD, PhD, Director4; T. Sugita, MD, PhD, Chief5; and K. Tomita, MD, PhD, Professor, Chairman1

1 Department of Orthopaedic Surgery Graduate School of Medical Science, Kanazawa University, 13-1 Takara-machi, Kanazawa-shi, Ishikawa-ken, 920-8641, Japan.
2 Department of Orthopaedic Surgery Ehime University Graduate School of Medicine, Shitsukawa, Shigenobu-cho, Onsengun, Ehime-ken, 791-0295, Japan.
3 Department of Orthopaedic Surgery Graduate School of Medicine, Sapporo Medical University, Minami 1-zyo Nishi 16, Chuo-ku Sapporo-shi, Hokkaido, 060-8543, Japan.
4 Department of Orthopaedic Surgery Odaikosei Hospital, 63-8 Odai Sahara, Taki, Mieken, 519-2404, Japan.
5 Department of Orthopaedic Surgery Hiroshima Prefectural Hospital, 1-5-54 Ujinakannda, Minami-ku, Hiroshima-shi, Hiroshima-ken, 734-8530, Japan.

Correspondence should be sent to Professor H. Tsuchiya; e-mail: tsuchi{at}med.kanazawa-u.ac.jp

We studied the safety of external fixation during post-operative chemotherapy in 28 patients who had undergone distraction osteogenesis (17, group A) or vascularised fibular grafting (11, group B) after resection of a tumour. Four cycles of multi-agent post-operative chemotherapy were administered over a mean period of 14 weeks (6 to 27). The mean duration of external fixation for all patients was 350 days (91 to 828). In total 204 wires and 240 half pins were used.

During the period of post-operative chemotherapy, 14 patients (11 in group A, 3 in group B) developed wire- and pin-track infection. A total of ten wires (4.9%) and 11 half pins (4.6%) became infected. Seven of the ten infected wires were in periarticular locations.

External fixation during post-operative chemotherapy was used safely and successfully for fixation of a vascularised fibular graft and distraction osteogenesis in 27 of 28 patients. Post-operative chemotherapy for malignant bone tumours did not adversely affect the ability to achieve union or cause hypertrophy of the vascularised fibular graft and had a minimal effect on distraction osteogenesis. Only one patient developed osteomyelitis which required further surgery.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General