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Background <p>Reconstruction following distal tibia tumor resection presents challenges in achieving stable skeletal support and functional restoration. Various biological reconstruction techniques, including fibula translocation and extracorporeal radiotherapy (ECRT) autograft, have been utilized. This study compares the clinical, radiological, and functional outcomes of these techniques to determine the optimal approach.</p> Methods <p>A retrospective observational study was conducted on 17 patients who underwent distal tibia tumor resection and biological reconstruction between 2007 and 2022, with a mean follow-up of 62.1 ± 38.6&#xa0;months. Ten patients received fibula translocation with plate fixation, while seven underwent ECRT autograft reconstruction (four with plate fixation and three with hindfoot nail fixation). Radiological union times, weight-bearing progression, functional scores, and complications were analyzed.</p> Results <p>ECRT autografts demonstrated a trend towards faster radiological union at both proximal (14.14 ± 3.29 vs. 22.10 ± 1.79&#xa0;months, <i>p</i> &lt; 0.001) and distal junctions (8.43 ± 1.90 vs. 11.60 ± 1.26&#xa0;months, <i>p</i> = 0.001). Earlier weight-bearing initiation was observed in ECRT patients (10.79 ± 5.82 vs. 36.90 ± 5.17&#xa0;weeks, <i>p</i> &lt; 0.001). Time to full weight-bearing was shorter in the ECRT group (19.86 ± 10.10 vs. 57.00 ± 9.76&#xa0;weeks, <i>p</i> &lt; 0.001). Within the ECRT subgroup, a faster full weight-bearing trend was observed with hindfoot nail fixation as compared to plate fixation (9.33 ± 1.04 vs. 27.75 ± 3.10&#xa0;weeks, <i>p</i> &lt; 0.001). Functional outcomes remained comparable between groups.</p> Conclusion <p>ECRT reconstruction facilitates earlier union and weight-bearing compared to fibula translocation. Hindfoot nail fixation further accelerates rehabilitation. While both techniques yield similar functional outcomes, ECRT autograft reconstruction may be preferred for its biomechanical and rehabilitative advantages.</p> Level of Evidence <p>Level III.</p>

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Biological Reconstruction Following Distal Tibia Tumor Resection: A Comparative Analysis of Fibula Translocation and Extracorporeal Radiotherapy Autograft

  • 期刊论文

  • 发表日期：

    2026年5月8日

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  • Abhijit Behera,
  • Love Kapoor,
  • Venkatesan Sampath Kumar,
  • Sameer Bakhshi,
  • Shah Alam Khan

摘要

Background

Reconstruction following distal tibia tumor resection presents challenges in achieving stable skeletal support and functional restoration. Various biological reconstruction techniques, including fibula translocation and extracorporeal radiotherapy (ECRT) autograft, have been utilized. This study compares the clinical, radiological, and functional outcomes of these techniques to determine the optimal approach.

Methods

A retrospective observational study was conducted on 17 patients who underwent distal tibia tumor resection and biological reconstruction between 2007 and 2022, with a mean follow-up of 62.1 ± 38.6 months. Ten patients received fibula translocation with plate fixation, while seven underwent ECRT autograft reconstruction (four with plate fixation and three with hindfoot nail fixation). Radiological union times, weight-bearing progression, functional scores, and complications were analyzed.

Results

ECRT autografts demonstrated a trend towards faster radiological union at both proximal (14.14 ± 3.29 vs. 22.10 ± 1.79 months, p < 0.001) and distal junctions (8.43 ± 1.90 vs. 11.60 ± 1.26 months, p = 0.001). Earlier weight-bearing initiation was observed in ECRT patients (10.79 ± 5.82 vs. 36.90 ± 5.17 weeks, p < 0.001). Time to full weight-bearing was shorter in the ECRT group (19.86 ± 10.10 vs. 57.00 ± 9.76 weeks, p < 0.001). Within the ECRT subgroup, a faster full weight-bearing trend was observed with hindfoot nail fixation as compared to plate fixation (9.33 ± 1.04 vs. 27.75 ± 3.10 weeks, p < 0.001). Functional outcomes remained comparable between groups.

Conclusion

ECRT reconstruction facilitates earlier union and weight-bearing compared to fibula translocation. Hindfoot nail fixation further accelerates rehabilitation. While both techniques yield similar functional outcomes, ECRT autograft reconstruction may be preferred for its biomechanical and rehabilitative advantages.

Level of Evidence

Level III.