A Case of Osteosarcoma in the Distal Femur Performed by Joint Preserving Operation with Epiphyseal Distraction

We report a 15-year-old boy with osteosarcoma in the distal femur on whom we performed Canadell's method to preserve the knee joint. On the MRI, the epiphyseal plate was patent and unaftected by the metaphyseal tumor. During preoperative chemotherapy, the epiphyseal plate was distracted by Orthofix external fixator up to 37mm for 24 days. En-block resection of the tumor including the newly formed callus was performed without exposing the metaphyseal surface. Reconstruction of the bone defect was undertaken by vascularized fibula and pasteurized autogenous bone graft. The patient was functionally excellent and free from local recurrence of the tumor until he died of metastasis three years after this procedure.