{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T02:38:00Z","timestamp":1785811080114,"version":"3.56.0"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,3,4]],"date-time":"2011-03-04T00:00:00Z","timestamp":1299196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Resection of diaphyseal malignant bone tumors is indicated for local control and impending pathological fracture or failure of prophylactic internal fixation. However, there are no large, long\u2010term studies analyzing the results of intercalary reconstruction using segmental metallic spacers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We present 24 patients treated with wide resection for primary or metastatic bone tumors involving the diaphysis of the femur, tibia, or humerus and reconstruction using a modular intramedullary diaphyseal segmental defect fixation system. The mean length of bone resection was 10\u2009cm. The postoperative complications and outcome were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At a mean follow\u2010up of 29 months, 17 patients were alive and 7 patients were dead of disease; no patient had local recurrence. Implant\u2010related complications occurred in 8 patients, the most common being mechanical loosening and rotational instability. Loosening was most common in reconstructions of more than 10\u2009cm length of bone resection. In all femoral reconstructions, mechanical failure occurred at the proximal stem. True limb length discrepancy of 2.0\u2009cm was observed in one patient. Wound healing complications were not observed; range of motion and function of the adjacent joints was within normal limits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The modularity, ease of application and preservation of the adjacent joints are major advantages of segmental modular prostheses; however, the complications' rate is high. Complications occur most often at the proximal stem in femoral reconstructions and reconstructions for more than 10\u2009cm length of bone resection. In these cases, the use of these implants should be reconsidered or not recommended. J. Surg. Oncol. 2011;104:83\u201390. \u00a9 2011 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.21893","type":"journal-article","created":{"date-parts":[[2011,3,6]],"date-time":"2011-03-06T13:10:45Z","timestamp":1299417045000},"page":"83-90","source":"Crossref","is-referenced-by-count":47,"title":["Outcome of the intramedullary diaphyseal segmental defect fixation system for bone tumors"],"prefix":"10.1002","volume":"104","author":[{"given":"Pietro","family":"Ruggieri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas F.","family":"Mavrogenis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Bianchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vassileios I.","family":"Sakellariou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Mercuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panayiotis J.","family":"Papagelopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,3,4]]},"reference":[{"key":"e_1_2_5_2_2","volume-title":"Surgery for bone and soft\u2010tissue tumors","author":"Simon MA","year":"1998"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000189203.38204.d5"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000179586.34727.5b"},{"key":"e_1_2_5_5_2","doi-asserted-by":"crossref","first-page":"54","DOI":"10.2106\/00004623-199501000-00008","article-title":"Massive allografts in the treatment of osteosarcoma and Ewings sarcoma in children and adolescents","volume":"77","author":"Alman BA","year":"1995","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000127132.12576.05"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200510000-00029"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200008000-00025"},{"key":"e_1_2_5_9_2","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/00003086-199109000-00025","article-title":"The use of bone allografts for limb salvage in high\u2010grade extremity osteosarcoma","volume":"270","author":"Gebhardt MC","year":"1991","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_5_10_2","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/00003086-198806000-00006","article-title":"The use of large allografts for tumor reconstruction and salvage of the failed total hip arthroplasty","volume":"231","author":"Gitelis S","year":"1988","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19820815)50:4<613::AID-CNCR2820500402>3.0.CO;2-L"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000141652.93178.10"},{"key":"e_1_2_5_13_2","doi-asserted-by":"crossref","first-page":"97","DOI":"10.2106\/00004623-199701000-00010","article-title":"The results of transplantation of intercalary allografts after resection of tumors: A long\u2010term follow\u2010up study","volume":"79","author":"Ortiz\u2010Cruz E","year":"1997","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_2_5_14_2","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1302\/0301-620X.78B4.0780652","article-title":"The outcome and functional results of diaphyseal endoprostheses after tumor excision","volume":"78","author":"Abudu A","year":"1996","journal-title":"J Bone Joint Surg Br"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199603000-00029"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B5.15491"},{"key":"e_1_2_5_17_2","first-page":"383","volume-title":"Musculoskeletal cancer surgery: Treatment of sarcomas and allied diseases","author":"Henshaw RM","year":"2001"},{"key":"e_1_2_5_18_2","first-page":"652","article-title":"The outcome and functional results of diaphyseal endoprostheses after tumor excision","volume":"78","author":"Abudu A","year":"1996","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_5_19_2","first-page":"403","article-title":"Limb salvage using distraction osteogenesis. 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