Annals of Surgical Oncology

, Volume 19, Issue 13, pp 4043–4051 | Cite as

Iliosacral Resections of Pelvic Malignant Tumors and Reconstruction with Nonvascular Bilateral Fibular Autografts

  • Jin Wang
  • Qinglian Tang
  • Xianbiao Xie
  • Junqiang Yin
  • Zhiqiang Zhao
  • Zhibin Li
  • Changye Zou
  • Gang Huang
  • Jingnan Shen
Bone and Soft Tissue Sarcomas



Iliosacral resection of pelvic malignant tumors and subsequent reconstruction have tested the ingenuity of orthopedic oncologists because of the difficulty of oncological wide resection and the complex biomechanics of the sacroiliac joint render reconstruction challenging. This study compared the functional and surgical outcomes of a biological reconstruction technique with the lack of reconstruction following iliosacral resection.


Twenty-six consecutive cases with malignant iliac tumors involving the sacrum were retrospectively reviewed. These cases underwent iliosacral resection (type I/IV) followed by no reconstruction or a biological reconstruction blinded to authors between 1997 and 2007. After iliosacral resection, 12 cases underwent reconstruction with nonvascular fibular grafts and plate and/or pedicle screw-rod; the other 14 cases did not undergo reconstruction.


The median follow-up was 84.42 (range, 32–165) months. The local recurrence rate in the reconstruction group was 8.33 % (1/12) with 14.29 % (2/14) in the group without reconstruction. The functional score of the biological reconstruction group was significantly higher than that of the no-reconstruction group as determined by Student’s t test. In the biological reconstruction group, bone fusion occurred in 91 % of cases and fibula hypertrophy was observed in 41.7 %. Complications included sciatic nerve palsy, broken screws, intractable pain, nonunion, pelvic oblique, and leg-length discrepancy.


After iliosacral resections of pelvic malignant tumors, the biologic reconstruction of these defects could restore spinopelvic stability and continuity. The double-barrel fibular autograft combined with the plate or pedicle screw-rod system is an effective reconstruction method for both optimal short- and long-term stability.


Local Recurrence Rate Functional Score Pelvic Ring Fibular Graft Oblique Pelvis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Supported by Sun Yat-sen University Clinical Research 5010 Program and the National Natural Science Foundation of China, serial no. 30872967, 81072193.


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Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Jin Wang
    • 1
  • Qinglian Tang
    • 1
  • Xianbiao Xie
    • 1
  • Junqiang Yin
    • 1
  • Zhiqiang Zhao
    • 1
  • Zhibin Li
    • 1
  • Changye Zou
    • 1
  • Gang Huang
    • 1
  • Jingnan Shen
    • 1
  1. 1.Muskulaskeletal Oncology Department, Department of Orthopaedic OncologyFirst Affiliated Hospital of Zhongshan UniversityGuangzhouChina

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