In JN from July 2012 to October 2014, five patients were treated with epiphysiolysis before tumor excision; there were three boys and two girls, with median age of 8 years (6–11 years) at surgery. Three neoplasms were located in distal femur and two in proximal tibia. On the basis of the Enneking staging system [3], in all five patients the disease was in stage IIB. All tumors were pathologically diagnosed as osteosarcoma, with four being of the osteoblastic type and one of the chondroblastic type. Preoperative chemotherapy was given in two courses on a neoadjuvant basis with cisplatin, Adriamycin and ifosfamide [4]. The reconstruction methods after tumor resection were distraction osteogenesis in one patient, alcohol inactivated autograft replantation in one patient, and microwave inactivation with external fixation in three patients.

In ZZ, between April 2010 and November 2012 [5], five patients were treated with epiphysiolysis before tumor excision; there were two boys and three girls, with median age of 13 years (9–15 years) at surgery. All five neoplasms were located in left distal femur. On the basis of the Enneking staging system, disease was at stage IIB. All tumors were pathologically diagnosed as osteosarcoma. Preoperative chemotherapy, which was given twice on a neoadjuvant basis, was with methotrexate, pirarubicin, carboplatin and ifosfamide. The reconstruction methods after tumor resection were inactivated autograft replantation in one patient, and allograft replantation with internal fixation in four patients.

In TJ from June 2012 to August 2014, four patients were treated with epiphysiolysis before tumor excision. The patients were three boys and one girl; median age at surgery was 7 years (6–9 years). One neoplasm was in the left distal femur, and three were in the proximal tibia. Three patients were in Enneking stage IIB; one boy was in stage III with pulmonary metastasis. The tumors of the three boys were pathologically diagnosed as osteosarcoma; the girl had a Ewing’s sarcoma. Preoperative chemotherapy was doxorubicin and cisplatin, which were given in three courses on a neoadjuvant basis. The method chosen for reconstruction after tumor resection was distraction osteogenesis in all four patients.

In XJ, one 8-year-old boy with a neoplasm in his left proximal tibia received epiphysiolysis before tumor excision, in May 2012. Disease was at stage IIB and pathologically diagnosed as osteosarcoma. Preoperative chemotherapy was in three courses, on a neoadjuvant basis, and with methotrexate, cisplatin, Adriamycin and ifosfamide. The method chosen for reconstruction was allograft replantation with vascularized fibula.

All patients received postoperative courses of neo-adjuvant chemotherapy. The follow-up schedule involves revisions every 3 months in the first and second year, and then every 6 months for the next 3 years. Postoperative results were evaluated according to the MSTS limb function score system. Statistical analysis involved calculation of the correlation between related factors, survival, and postoperative function.