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All patients were free from disease when reviewed at a minimum of two years postoperatively (mean 49.7 months (24 to 96). <\/jats:p><jats:p> There were no cases of infection. Primary union was achieved after a median of nine months (interquartile range 7 to 11). Five host-donor junctions (16%) united only after a second procedure. Primary union recurred faster at metaphyseal junctions (94% (15) at a median of 7.5 months (interquartile range 4 to 12)) than at diaphyseal junctions (75% (12) at a median of 11.1 months (interquartile range 5 to 18)). <\/jats:p><jats:p> Post-operatively, the median Musculoskeletal Tumour Society score was 85% (interquartile range 75 to 96) and the median Toronto Extremity Salvage score 94% (interquartile range 82 to 99). The Mankin score gave a good or excellent result in 14 patients (88%). <\/jats:p><jats:p> The range of movement of the knee was significantly worse when the extracorporeally irradiated autografts were fixed by plates rather than by nails (p = 0.035). <\/jats:p><jats:p> A total of 16 (62%) of the junctions of the vascularised fibular grafts underwent hypertrophy, indicating union and loading. <\/jats:p><jats:p> Extracorporeal irradiation autografting with supplementary vascularised fibular grafting is a promising biological alternative for intercalary reconstruction after wide resection of malignant bone tumours of the femur. <\/jats:p>","DOI":"10.1302\/0301-620x.89b3.18508","type":"journal-article","created":{"date-parts":[[2007,3,13]],"date-time":"2007-03-13T19:09:59Z","timestamp":1173812999000},"page":"366-371","source":"Crossref","is-referenced-by-count":74,"title":["Intercalary femoral reconstruction with extracorporeal irradiated autogenous bone graft in limb-salvage surgery"],"prefix":"10.1302","volume":"89-B","author":[{"given":"A. 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