4.5 Article

Epiphyseal distraction prior to resection in paediatric bone sarcomas

Journal

BONE & JOINT JOURNAL
Volume 105B, Issue 1, Pages 11-16

Publisher

BRITISH EDITORIAL SOC BONE & JOINT SURGERY
DOI: 10.1302/0301-620X.105B1.BJJ-2022-0722.R2

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Canadell's technique involves pre-resection Type I epiphysiolysis with continuous distraction using an external fixator, aiming to achieve safe margin resection, avoid joint reconstruction, and preserve growth capacity, playing a significant role in the treatment of paediatric bone sarcomas.
Paediatric bone sarcomas are a dual challenge for orthopaedic surgeons in terms of tumour resection and reconstruction, as it is important to minimize functional and growth problems without compromising survival rates. Canadell's technique consists of a Type I epiphysiolysis performed using continuous distraction by an external fixator prior to resection. It was designed to achieve a safe margin due to the ability of the physeal cartilage to be a barrier to tumour spread in some situations, avoiding the need for articular reconstruction, and preserving the growth capacity most of the times. Despite initial doubts raised in the scientific community, this technique is now widely used in many countries for the treatment of metaphyseal paediatric bone sarcomas. This annotation highlights the importance of Canadell's work and reviews the experience of applying it to bone sarcoma patients over the last 40 years.

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