A 2-stage Distal Femur Reconstruction with Expandable Endoprosthesis in a Pediatric Patient Presenting with a Pathologic Fracture through an Osteosarcoma

  • Jasson Louie R. Arcinue
  • Edward H.M. Wang
  • Gregorio Marcelo S. Azores
Keywords: Osteosarcoma, Expandable tumor endoprosthesis, Limb salvage surgery


Osteosarcoma in pediatric patients has traditionally been treated with amputation, especially if there is a pathologic fracture through the tumor.
We report the case of a 12-year-old boy who sustained a pathologic fracture through distal femoral osteosarcoma. After neoadjuvant chemotherapy, he underwent limb saving surgery: wide excision of the osteosarcoma followed by a second-stage reconstruction with an expandable tumor endoprosthesis. He has a functional score of 93% and is free of disease 8 years since diagnosis and 2 years since the end of lengthening.
This is the first reported case in Philippine medical literature of limb saving surgery in osteosarcoma reconstructed with an expandable endoprosthesis.