Optimizing proximal fibula tumor resection: “The open door technique” for better surgical access and outcomes - A case series
Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".