Treatment of Adamantinoma in Tibial Diaphysis by Hemicortical Resection and Strut Allograft

Abstract

Introduction: Adamantinoma is a primary low-grade, malignant bone tumor, of unknown histogenesis which is a rare neoplasm, comprise only 0.1–0.5% of all primary bonetumors. It is slightly more common in men than women, with a ratio of 5:4. Wide tumour resection and limb salvage is the treatment of choice. Case report: A 24 year female reffered with chief complaints of pain and limping lasting for approximately 2 years. Plain X-ray showed an expansile multicystic lesion at the diaphysis of the left tibia anterior cortex with periosteal reaction . We used an oscillating bone saw to perform a total resection of the lesion preserving the anterior cortex. Tibial defect created with this resection was replaced with a 14 cm. long strut cadaveric femoral allograft that fixed to tibia with a dynamic commpresive plate (DCP) and screws. Discussion: In surgical treatment of Adamantinoma, total resection was not performed and remain intact posterior cortex to increased the patient satisfaction, at the same time, bone fixation and early weight bearing at the postoperative. We believe that the defect will be able to union with appropriate fixation of the allograft also be long size.