Optimizing proximal fibula tumor resection: “The open door technique” for better surgical access and outcomes - A case series
Notice bibliographique
Résumé
Proximal fibula tumors pose significant surgical challenges due to their proximity to vital neurovascular structures, including the common peroneal nerve. Traditional resection techniques often require extensive tissue manipulation, which can lead to complications such as peroneal nerve injury and knee instability. This study introduces and evaluates the “open door technique,” designed to enhance surgical visualization and access, thereby reducing complications while achieving oncologic control. We conducted a retrospective cohort study of 31 patients who underwent proximal fibula tumor resection using the “open door technique” from 2015 to 2022. Patient demographics, tumor characteristics, and functional outcomes were documented. Preoperative imaging and a standardized surgical approach were employed, with follow-up assessments including the Musculoskeletal Tumor Society (MSTS) score and the Toronto Extremity Salvage Score (TESS). Descriptive statistics and comparative analyses were applied to evaluate surgical and functional outcomes. The “open door technique” achieved negative resection margins in 93.5 % of cases, with a recurrence rate of 6.5 % over a mean follow-up period of 36 months. Postoperative complications included permanent peroneal nerve injury in 12.9 % of patients and transient nerve injury in 9.7 %, both lower than rates typically associated with traditional techniques. Functional outcomes were favorable, with 87.1 % of patients achieving good to excellent MSTS and TESS scores, indicating practical neurovascular and ligamentous structure preservation. The “open door technique” provides an effective, function-sparing approach for proximal fibula tumor resection, balancing oncologic control with reduced neurovascular complications and improved functional outcomes. These findings support its potential as a valuable addition to orthopedic oncology practices. Further studies are recommended to confirm its applicability across a broader patient population. • The “open door technique” significantly improves surgical visualization, allowing safer dissection and better preservation of neurovascular structures. • Negative resection margins were achieved in 93.5% of cases, indicating strong oncologic control. • Peroneal nerve complications were reduced compared to traditional methods, with only 12.9% experiencing permanent injury. • Functional outcomes were favorable, with over 87% of patients achieving good to excellent MSTS and TESS scores. • Local recurrence was low (6.5%), and no distant metastases were observed during a mean follow-up of 36 months.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».