{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T12:47:26Z","timestamp":1784551646474,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,8,11]],"date-time":"2019-08-11T00:00:00Z","timestamp":1565481600000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the validity of a modified scoring system (MSS) for inferring the bony quality of tumor\u2010bearing diaphyses and predicting the risk of reconstructive failure after devitalized bone replantation (DBR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective cohort study, we reviewed the records of 30 patients surgically treated for diaphyseal malignancies between 1996 and 2015. There were 18 male and 12 female subjects; the average age was 34.0\u2009\u00b1\u200924.5\u2009years (8\u201382\u2009years). Tumor locations comprised the femur (21), the humerus (4), the tibia (3), the radius (1), and the fibula (1). Histological diagnoses included osteosarcoma (13), metastases (4), Ewing sarcoma (3), chondrosarcoma (3), malignant fibrohistiocytoma (2), periosteal osteosarcoma (1), Langerhans cell sarcoma (1), lymphoma (1), rhabdomyosarcoma (1), and malignant giant cell tumor (1). All primary tumors were rated as stage IIB. Twenty patients underwent DBR. Prosthetic procedures and segmental autografting\/allografting were performed in 7 and 3 cases, respectively. MSS (comprising 5 elements: pain, tumor location, bone destruction, localized dimension, and longitudinal dimension) for each patient was calculated in accordance with their preoperative presentations. Outcome measurements included oncological results, outcomes of reconstructions, complications, and functional preservation, presented using the musculoskeletal tumor society (MSTS) scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Follow up was available in 29 cases for an average duration of 61.0\u2009\u00b1\u200949.9\u2009months (12\u2013152\u2009months). Infection occurred in 2 patients (6.9%), primary nonunion in 6 (27.3%), metastases in 9 (31.9%), recurrences in 4 (13.8%), and deaths in 7 (24.1%); 1 subject underwent amputation due to recurrence following endoprosthetic replacement (3.4%). In the DBR group, fractures occurred in 4 cases (21.1%) and nonunion in 5 (25%); internal fixation was related to nonunion (nails, 44.4% <jats:italic>vs<\/jats:italic> plates, 9.1%, <jats:italic>P<\/jats:italic> = 0.02). MSS was associated with fractures of devitalized autografts (11.0\u2009\u00b1\u20091.2 <jats:italic>vs<\/jats:italic> 8.3\u2009\u00b1\u20091.8, <jats:italic>P<\/jats:italic> = 0.01); the system was efficacious in predicting chances of fractures of these grafts (<jats:italic>P<\/jats:italic> = 0.02). MSS\u2009\u2265\u200910 (with false positive rate\u2009\u2264\u20096.7%) suggested increased fracture probability (\u226522.7%) after DBR; therefore, 10 was considered a cutoff value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Diaphyseal malignancies with MSS\u2009\u226510 may contraindicate DBR for increased chances of reconstructive failure. In this situation, alternative procedures are advisable. Further investigations are warranted to assess the efficacy of MSS in implying the validity of DBR for diaphyseal malignancies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12502","type":"journal-article","created":{"date-parts":[[2019,8,12]],"date-time":"2019-08-12T01:39:21Z","timestamp":1565573961000},"page":"586-594","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy of a Modified Scoring System to Facilitate Surgical Decision\u2010making for Diaphyseal Malignancies: When is Devitalized Tumor\u2010bearing Autograft of Value?"],"prefix":"10.1111","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6657-3237","authenticated-orcid":false,"given":"Yu","family":"Chen","sequence":"first","affiliation":[{"name":"Orthopaedic Department 960 Hospital of People's Liberation Army  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiu\u2010chun","family":"Yu","sequence":"additional","affiliation":[{"name":"Orthopaedic Department First Hospital of China Medical University  Shenyang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.3928\/0147-7447-19950101-05","article-title":"Osteosarcoma of the diaphysis of long bones: clinicopathologic features and treatment of 51 cases","volume":"18","author":"Sim FH","year":"1995","journal-title":"Orthopedics"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-009-0675-2"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.96B9.33230"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000179586.34727.5b"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200510000-00029"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000141652.93178.10"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000152898.03736.40"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-015-4588-z"},{"key":"e_1_2_7_10_1","first-page":"171","article-title":"Custom endoprosthetic reconstruction for malignant bone disease in the humeral diaphysis","volume":"77","author":"McGrath A","year":"2011","journal-title":"Acta Orthop Belg"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2013.09.025"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt252"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-015-4447-y"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00776-010-1458-0"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000367799"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0033492"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7819-10-105"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2014.06.003"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12237"},{"key":"e_1_2_7_20_1","first-page":"256","article-title":"Metastatic disease in long bones. A proposed scoring system for diagnosing impending pathologic fractures","volume":"415","author":"Mirels H","year":"1989","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_7_21_1","first-page":"106","article-title":"A system for the surgical staging of musculoskeletal sarcoma","volume":"415","author":"Enneking WF","year":"1980","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199301000-00035"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-014-2584-7"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2012.03.021"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00834"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0246-z"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-540-77960-5_9"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-011-0218-2"},{"key":"e_1_2_7_29_1","first-page":"48","article-title":"Which is the best method of sterilization of tumour bone for reimplantation? A biomechanical and histopathological study","volume":"9","author":"Singh VA","year":"2010","journal-title":"Biomed Eng"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-015-1234-9"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-017-5273-1"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199701000-00010"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000068"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.4055\/cios.2014.6.3.312"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000599"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.96B1.31135"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(01)00183-8"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1054\/arth.2002.34817"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-010-1192-4"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.5606\/ehc.2015.06"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.12502","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.12502","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.12502","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T06:16:17Z","timestamp":1694326577000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.12502"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":39,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1111\/os.12502"],"URL":"https:\/\/doi.org\/10.1111\/os.12502","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8]]},"assertion":[{"value":"2018-12-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-08-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}