Limb salvage and rotationplasty for osteosarcoma in children.

Limb salvage was previously described for patients with osteogenic sarcoma who had resectable lesions. In the very young child the usual methods of reconstruction are not applicable due to the resulting major leg-length inequality. One solution is to resect the lesion in accordance with good cancer surgery guidelines and then perform a rotationplasty of the Van Nes type. The ankle then functions as a knee joint, and the final result is a below-knee amputation rather than a high above-knee amputation. Functional results in two patients were remarkably good.