Classifying the location of osteosarcoma with reference to the epiphyseal plate helps determine the optimal skeletal resection in limb salvage procedures

Between 1989 and 1996, 21 skeletally immature patients were treated for ost eosarcoma of the extremity. Their average age was 12.6 years (range 9-16 ye ars). We classified the location and extent of the lesion in bone on magnet ic resonance imaging (MRI) with reference to the growth plate and joint mar gin into five subtypes. This classification served as a guide for the level of resection and the type of reconstruction required for a limb salvage pr ocedure. All patients received neoadjuvant chemotherapy using a modified T1 0 protocol before the definitive operation. These patients were followed up for periods ranging from 11-86 months, with a mean of 35.5 months. Patient s were assessed for (1) local tumour recurrence, (2) metastatic disease, (3 ) allograft complications and (4) extremity function and joint stability. E xcellent function was retained in 2, good in 13 and fair function in 6 pati ents. The MRI classification proved useful for the resection and provides a n insight into the possible functional outcomes.