Rotationplasty Type BIIIa according to Winkelmann - Electromyography and gait analysis

After resection of a malignant bone tumor of the femur, rotationplasty is c onsidered a treatment option in addition to other limb salvage procedures s uch as endoprosthetic replacement, allograft, or autograft reconstruction. A Type B IIIa rotationplasty is indicated when the tumor involves the total femur or when skip lesions are detected. After the total femur is resected , the lateral tibial plateau is placed into the acetabulum after rotating t he tibia and foot segment 180 degrees, Eight patients at an average age of 5.9 years underwent a rotationplasty Type B IIIa at the authors' institutio n. After a median followup of 59.6 months (range, 24-86 months) the clinica l results were excellent and the functional status according to the criteri a of the Musculoskeletal Tumor Society was good (23 of 30 points), In elect romyographic analysis the muscle activity of the affected leg revealed good function of the stance and the swing phase muscles according to their new function with comparable amplitudes to the unaffected limb. The kinematics (range of motion of the hip and knee) were slightly asymmetric, Gait analys is showed a slight lateral trunk lean over the ipsilateral limb with reduce d joint moment, All patients had full weightbearing ability. Remodeling of the tibial plateau into a round form mimicking a new femoral head is confir med by radiographs and magnetic resonance imaging scans. In young children with a tumor of the total femur, rotationplasty Type B IIIa is a good treat ment modality with excellent clinical and good functional results, The elec tromyographic and gait analysis data underscore a good functional restorati on of gait after rotationplasty.