Limb-Salvage Options in Growing Children with Malignant Bone Tumors of the Lower Extremity

Limb-salvage options fall into 2 main categories, biological reconstruction and endoprosthetic arthroplasty, each of which has technical and functional considerations that are key to determining the optimal treatment choice. Limb-salvage surgery in growing children presents a unique set of challenges, with careful planning to ensure the recreation and maintenance of limb-length equality and a durable construct for longterm function into adulthood. Limb preservation should not compromise a patient's oncological results, and functional outcomes and quality of life should be no worse than would be the case after amputation. Amputation and rotationplasty are excellent oncological and functional options and should always be discussed as alternatives to limb salvage. Advances in endoprosthetic design and biological reconstructive techniques afford limb-salvage options following oncological resections in the growing child that are ideally tailored to the patient's unique anatomical and functional needs.