A rotation-plasty procedure was used in four children with osteosarcoma
of the distal part of the femur. The results showed that this procedure,
combined with en bloc wide excision of the proximal part of the tibia and
the distal part of the femur including the knee joint, appears to be an
adequate surgical treatment for osteosarcoma of the distal part of the
femur in children. None of our patients to date had either clinical or
radiographic evidence of local recurrence during follow-up periods of
between twenty-seven and fifty-eight months. One patient, however, died of
widespread metastatic disease. Despite postoperative adjuvant chemotherapy
with high doses of methotrexate, there have been no problems with
wound-healing and early fitting of a prosthesis was possible. Because of
the success in preventing local recurrence in these four patients, we now
generally employ this method in the surgical management of osteosarcoma of
the distal part of the femur in children.