Surgical management of 121 benign proximal fibula tumors

Matthew Abdel, Panayiotis J. Papagelopoulos, Mark E. Morrey, Doris E. Wenger, Peter S. Rose, Franklin H. Sim

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: Tumors of the fibula comprise only 2.5% of primary bone lesions. Patients with aggressive benign tumors in the proximal fibula may require en bloc resection. Peroneal nerve function, knee stability, and recurrence are substantial concerns with these resections. The incidence and fate of these complications is not well-known owing to the small numbers of patients in previous reports. Questions/purposes: We therefore analyzed the incidence of peroneal nerve palsy, knee stability, and local recurrence following surgical treatment of benign proximal fibula tumors. Methods: We retrospectively reviewed the charts of 120 patients (121 tumors) with histologically confirmed aggressive benign tumors of the proximal fibula. There were 56 males and 64 females with an average age of 24 years (range, 2-64 years). The most common diagnosis was osteochondroma (38%) followed by giant cell tumor (19%). Pain (94%), palpable mass (39%), and peroneal nerve symptoms (12%) were the most common presenting symptoms. Of the 121 tumors, 56 (46%) underwent en bloc resection. The minimum followup was 2 years (mean, 9 years; range 2 to 49 years; median, 7.4 years). Results: Postoperative complications included nine peroneal nerve palsies (six transient, three permanent), one deep venous thrombosis, and one wound dehiscence. No long-term knee instability was seen with repair of the lateral collateral ligament. Ten patients had recurrences, with 70% of local recurrences occurring in patients who underwent intralesional excision. Conclusions: Given the higher recurrence rate with curettage, patients with aggressive proximal fibula tumors benefit from en bloc resection. The overall morbidity is low, but postoperative permanent peroneal palsy remains a concern (3%).

Original languageEnglish (US)
Pages (from-to)3056-3062
Number of pages7
JournalClinical orthopaedics and related research
Volume468
Issue number11
DOIs
StatePublished - Jan 1 2010

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Fibula
Peroneal Nerve
Recurrence
Neoplasms
Paralysis
Knee
Ankle Lateral Ligament
Osteochondroma
Giant Cell Tumors
Curettage
Incidence
Venous Thrombosis
Morbidity
Bone and Bones
Pain
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Abdel, M., Papagelopoulos, P. J., Morrey, M. E., Wenger, D. E., Rose, P. S., & Sim, F. H. (2010). Surgical management of 121 benign proximal fibula tumors. Clinical orthopaedics and related research, 468(11), 3056-3062. https://doi.org/10.1007/s11999-010-1464-8

Surgical management of 121 benign proximal fibula tumors. / Abdel, Matthew; Papagelopoulos, Panayiotis J.; Morrey, Mark E.; Wenger, Doris E.; Rose, Peter S.; Sim, Franklin H.

In: Clinical orthopaedics and related research, Vol. 468, No. 11, 01.01.2010, p. 3056-3062.

Research output: Contribution to journalArticle

Abdel, M, Papagelopoulos, PJ, Morrey, ME, Wenger, DE, Rose, PS & Sim, FH 2010, 'Surgical management of 121 benign proximal fibula tumors', Clinical orthopaedics and related research, vol. 468, no. 11, pp. 3056-3062. https://doi.org/10.1007/s11999-010-1464-8
Abdel, Matthew ; Papagelopoulos, Panayiotis J. ; Morrey, Mark E. ; Wenger, Doris E. ; Rose, Peter S. ; Sim, Franklin H. / Surgical management of 121 benign proximal fibula tumors. In: Clinical orthopaedics and related research. 2010 ; Vol. 468, No. 11. pp. 3056-3062.
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AB - Background: Tumors of the fibula comprise only 2.5% of primary bone lesions. Patients with aggressive benign tumors in the proximal fibula may require en bloc resection. Peroneal nerve function, knee stability, and recurrence are substantial concerns with these resections. The incidence and fate of these complications is not well-known owing to the small numbers of patients in previous reports. Questions/purposes: We therefore analyzed the incidence of peroneal nerve palsy, knee stability, and local recurrence following surgical treatment of benign proximal fibula tumors. Methods: We retrospectively reviewed the charts of 120 patients (121 tumors) with histologically confirmed aggressive benign tumors of the proximal fibula. There were 56 males and 64 females with an average age of 24 years (range, 2-64 years). The most common diagnosis was osteochondroma (38%) followed by giant cell tumor (19%). Pain (94%), palpable mass (39%), and peroneal nerve symptoms (12%) were the most common presenting symptoms. Of the 121 tumors, 56 (46%) underwent en bloc resection. The minimum followup was 2 years (mean, 9 years; range 2 to 49 years; median, 7.4 years). Results: Postoperative complications included nine peroneal nerve palsies (six transient, three permanent), one deep venous thrombosis, and one wound dehiscence. No long-term knee instability was seen with repair of the lateral collateral ligament. Ten patients had recurrences, with 70% of local recurrences occurring in patients who underwent intralesional excision. Conclusions: Given the higher recurrence rate with curettage, patients with aggressive proximal fibula tumors benefit from en bloc resection. The overall morbidity is low, but postoperative permanent peroneal palsy remains a concern (3%).

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