الفهرس 
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Abstract
Due to early diagnosis, effective chemotherapy, and precise preoperative imaging techniques, many tumors involving the metaphyseo-diaphyseal regions of long bones can be resected with joint preservation. The intercalary tumor resection results in a segmental bone defect and can represent a challenging reconstructive problem.
Biological reconstructions performed via reuse of the resected tumor-bearing bone have become increasingly popular; they include the use of extracorporeal irradiation, autoclaving, pasteurization or freezing. A major advantage of these techniques is that the reconstructive procedure can be performed more easily when the dimensions of the defective excised bone match the grafted replacement bone. Yamamoto et al. have described the use of freezing with liquid nitrogen at −196 °C to treat the tumor-bearing bone; viable tumor cells are destroyed by inducing ice crystal formation and cell dehydration. Only one freeze cycle at −196 °C for 20 minutes, followed by a thawing procedure, is required to kill tumor cells.
This study was performed to evaluate the clinical and oncological outcomes of 34 patients who underwent intercalary frozen autograft reconstruction for malignant bone and soft tissue tumors of the extremities, and to observe the time required for bone integration and the incidence of any ensuing complications.
At the last follow-up, 20 patients remained disease-free, seven patients had no evidence of disease, five patients were alive with disease, and two patients died of disease.
The five- and ten-year survival rates of the patients were 97% and 94.1%, respectively. The five- and ten-year survival rates of the frozen autografts were 91.2%, with survival rates of 94.4% and 87.5% for PFP and FFP autografts, respectively. The mean ISOLS score for all patients was 26.1 points (86.79%) and ranged between 30% and 100%, and for the 31 patients who retained their frozen autografts the mean ISOLS score was 27 points (90%).
Final bony union of the frozen autografts was achieved in 33 cases (97%). The average bone union time was 10 months for the 29 patients who did not undergo additional surgery (9.8 months for the patients who received PFP autografts and 10.2 months for the patients treated with FFP autografts).
There were five cases (14.7%) of nonunion; among them, four cases were treated by bone graft augmentation at the nonunion site and one case required removal of the frozen autograft due to infection and a vascularised fibular graft was used instead.