الفهرس 
Limb-salvage therapyOnly 14 pages are availabe for public view
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Abstract
Summary
T
he use of liquid nitrogen for management of the primary lesion in osteosarcoma, was first described in 1984 by Marcove et al 79.
Surgical use of liquid nitrogen was first reported by Cooper 80 in 1962. Since then, many tumors have been treated locally with liquid nitrogen.56.57
In the field of orthopedics, Gage et al.8 researched the effects of liquid nitrogen in 1966 in bones of dogs, and Marciani et al.83 reported on the good remodeling quality of liquid nitrogen-treated bone. Marcove and Miller 84 reported the first clinical use of recycled tumor bearing bone segments in 1969. Orthopedically, liquid nitrogen is now used for benign or borderline malignant tumors, being applied directly to the lesions.85-88 Reimplantation of resected bone treated with liquid nitrogen has already been reported for oralmaxillofacial surgery.89-92
Dong et al.90 reported their clinical results with reimplanted bone for patients with benign and malignant bone tumors, as well as their findings concerning the merits of liquid nitrogen treatment. The mechanisms of cell death caused by freezing are complex, but the main factors are ice crystal formation and dehydration of the cells & ischemic infarction due to thrombosis of the microcirculation.
Yamamoto et al. described the use of freezing to treat the bone containing the tumor using liquid nitrogen at −196∘ C, which was used as a cryogenic agent used to destroy the tumor cells. 93
Tumor cells are considered more sensitive to low temperatures than normal cells.94 Helpap 95 found that rapid freezing and slow thawing causes the most effective damage to tumor cells. features rapid freezing and slow thawing steps, which can cause fatal damage to the treated cells; they devised a method for treating autografts that utilizes the hypothermic effect of liquid nitrogen and established a one-cycle liquid nitrogen protocol that included 20 min in liquid nitrogen, 15min in room air, and 10 min to in physiological saline.
There are two techniques to recycle bone bearing tumor in liquid nitrogen ether FFP through en block resection of bone bearing tumor and to be recycled separately in liquid nitrogen then fixed in proximal and distal ends and PFP through performing one side osteotomy maintaining the continuity of the bone with the body and immersing the bone bearing segment in liquid nitrogen and then fix the segment in its position after completing the recycling.
We searched to clarify differences between these two methods systematically regarding union time, functional scores, outcomes and complications as infection, graft failure, recurrence & skin necrosis.