vascularised fibula graft

Aim

Tumour removal to gain local control & minimize recurrence while maintaining functional limb 

Margins

1.  Intralesional

Within lesion

- macroscopic tumour remains

2.  Marginal

Within reactive zone

- microscopic tumour remains

3.  Wide 

Management Summary

Stage 0

Natural history mixed

- depends on size of lesion and diagnosis

- treat if becomes asymptomatic

- may benefit from bisphosphonates

Stage 1 / Normal X-ray, abnormal MRI

Forage: 80% G/E

Bisphosphonates

Stage 2 / Abnormal X-ray with cysts and sclerosis

A:  As for Stage I