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Log in through your institution a review of non-invasive growing endoprosthetic replacements c armitstead , c paliobeis , c williams and r grimer royal orthopaedic hospital, birmingham, uk abstract introduction: the use of extendible endoprosthetic implants in the skeletally immature has been used for just under 30 years. generic viagra from india safe generic viagra cheapest Limb salvage has become a realistic alternative to those children presenting with primary bone sarcomas. viagra professional 20 mg We aim to review the use of an implant which uses a non-invasive mechanism of adjusting the length of the prosthesis, during the growth phase. viagra soft tabs cheap Method: a retrospective review of consecutive patients undergoing primary or revision endoprosthetic replacement with non-invasive extensible implants, was undertaken.
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Between january 1993 and february 2008, 34 children were treated with non-invasive extensible endoprosthetic replacements, 26 distal femur, 5 total femurs, 3 proximal tibias and 1 proximal femur.
Results: the underlying pathology, requiring excision, was ewings sarcoma in 4 patients and osteosarcoma in the remaining 30 patients.
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Most underwent pre-operative chemotherapy and 2 patients died of their disease.
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Four operations were secondary procedures following previous non-grower implant failures (1 infection of previous epr, 1 im nail non-union, 1 failed allograft and a revision of a proximal femoral epr to a total femoral prosthesis).
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Five patients required revision of the primary prosthesis (2 with motor failures, 3 due to prosthesis infections).
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Mean time to start lengthening from surgery was 12.
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The mean number of lengthenings was 4 with an average total length of 30 mm achieved, mean leg length difference was 0.
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All lengthenings were undertaken with the patient fully alert, no adverse incidents occurred at the time or after lengthening. free viagra sample pack canada Discussion: the non-invasive prostheses show promise in handling the difficult problem of limb preservation in a growing child,.
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