Disarticulation of the hip and hemipelvectomy have been the only
surgical alternatives available for the adequate local control of malignant
tumors of the proximal part of the femur in patients who are still growing.
The use of proximal or total femoral implants is restricted to patients who
have reached skeletal maturity. To improve the quality of survival for
patients who have not yet reached skeletal maturity and have a malignant
tumor of the proximal part of the femur, I have modified the rotationplasty
procedure described by Van Nes for use in such lesions. After en bloc
resection of the tumor, the distal part of the femur with the knee joint
and leg is rotated 180 degrees and fixed to the lateral side of the pelvis.
The knee joint then functions as a hinge hip joint and the ankle joint
functions as a knee joint. This procedure was performed in eight patients,
three of whom were followed for more than two years. All patients walked
well with a prosthesis and the functional results were excellent. At the
time of writing, there had been no recurrence of a tumor or pulmonary
metastasis.