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Is There a Reliable Method to Predict the Limb Length Discrepancy after Chemotherapy and Limb Salvage Surgery in Children with Osteosarcoma?
Background:For a child with osteosarcoma,prediction of the limb length discrepancy at maturity is important when planning for limb salvage surgery.The purpose of this study was to provide a reliable prediction method.Methods:A retrospective review of Chinese children receiving chemotherapy for osteosarcoma before skeletal maturity was conducted.Standing full-length radiographs of the lower extremity were used for length measurements.Length-for-age curves were constructed using the LMS method.The lower limb multiplier for a specific age and gender was calculated using the formula M =Lm/L,where M was the gender-and age-specific multiplier,Lm was the bone length at maturity,and L was the age-specific bone length.Prematurity and postmaturity radiographs were used to assess the accuracy of the prediction methods.Results:A total of 513 radiographs of 131 boys and 314 radiographs of 86 girls were used to calculate the coefficients of the multiplier.The multipliers of 8-,9-,10-,11-,12-,13-,14-,15-,16-,17-,and 18-year-old boys after chemotherapy for osteosarcoma were 1.394,1.306,1.231,1.170,1.119,1.071,1.032,1.010,1.004,1.001,and 1.000,while for girls at the same ages,the multipliers were 1.311,1.221,1.146,1.092,1.049,1.021,1.006,1.001,1.000,1.000,and 1.000,respectively.Prematurity and postmaturity femoral and tibial lengths of 21 patients were used to assess the prediction accuracy.The mean prediction error was 0 cm,0.8 cm,and 1.6 cm for the multiplier method using our coefficients,Paley's coefficients,and Anderson's method,respectively.Conclusions:Our coefficients for the multiplier method are reliable in predicting lower limb length growth of Chinese children with osteosarcoma.
Hai-Rong Xu
Xiao-Hui Niu
作者单位：
Department of Orthopedic Oncology Surgery, Beijing Jishuitan Hospital, The Fourth Clinical Medical College of Peking University, Beijing 100035, China
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例子： 对自己的错误和缺点，决不可～，应该去寻求他人的帮助并尽快改正。
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