患有骨肉瘤的患者越来越倾向选择肢体挽救手术。这可能会导致骨骼未发育完全的患者出现肢体长度不一致（LLD）的问题。我们将治疗方案综合成为一个算法并报告我们的结果。我们回顾了股骨干到胫骨干的任何部位上出现骨肉瘤的12岁及以下患者。我们的临床路径规定了：MetaDiaphyseal损伤的患者需要进行间质异体移植重建；骺端损伤和预计LLD小于5 cm的患者需要进行关节骨异体移植；预计LLD超过5 cm的患者需要进行可延伸义肢手术。符合纳入标准的20名患者中，有11名患者进行关节骨异体移植手术，5名患者进行可延伸义肢手术，4名患者进行间质异体移植手术；中位年龄为11.5岁；中位随访时间为8.2年；最终中位LLD为1.6 cm。其中5名患者进行了对侧骺盘融合手术，2名患者接受了对侧股骨缩短手术，并进行了中位为6次（范围4-8次）的可延伸义肢伸长手术。四名患者残留LLD超过3 cm。共有8名患者进行了13次修复手术，2名患者进行了截肢手术。对于骨肉瘤儿童膝关节的肢体挽救手术可以通过多种技术进行管理，并在LLD方面产生满意的结果。鉴于LLD和再建手术的高风险，仔细的术前计划和共同决策是必需的。证据等级：三级回顾性比较研究。版权所有 © 2023 Wolters Kluwer Health, Inc. 保留所有权利。

Patients with bone sarcomas increasingly choose limb salvage. This can lead to issues with limb length discrepancy (LLD) for the skeletally immature. We synthesize management options into an algorithm and report our results. Patients with bone sarcomas involving any location from the femoral diaphysis to the tibial diaphysis 12 years or younger were reviewed. Our clinical pathway prescribed patients with metadiaphyseal lesions to intercalary allograft reconstruction, epiphyseal lesions and less than 5 cm expected LLD to osteoarticular allograft and patients with more than 5 cm expected LLD to extendable prosthesis. Twenty patients met inclusion criteria: 11 with osteoarticular allografts, 5 with extendable prostheses and 4 with intercalary allografts; median age 11.5 years; median follow-up 8.2 years; and final median LLD 1.6 cm. Five patients had contralateral epiphysiodesis, two patients underwent contralateral femoral shortening and a median of 6 (range 4-8) lengthenings were performed for extendable prostheses. Four patients had residual LLD over 3 cm. There were 13 revisions in 8 patients and 2 amputations. Limb-salvage in paediatric bone sarcoma of the knee can be managed with multiple techniques producing satisfactory results in regards to LLD. Careful pre-operative planning and shared decision making is a requisite given the high rate of secondary procedures for both LLD and reconstructive failures. Level of evidence: Level III Retrospective Comparative Study.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.