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A 13-year-old girl is referred for a painful progressive valgus deformity of the right knee. Examination reveals an antalgic gait with an obvious valgus deformity. The right distal femur has a palpable, tender mass with erythema and warmth. Figures 4a and 4b show a clinical photograph and a radiograph. Management should consist of
needle biopsy of the distal femur.
open reduction and internal fixation with a locking plate.
closed reduction and fixation with a reamed antegrade locking intramedullary nail.
referral to an orthopaedic oncologist for staging studies, biopsy, and definitive management.
IV antibiotics for 6 weeks.
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A 15-year-old boy has a mass at the knee. Radiographs show an aggressive tumor involving the proximal tibia, and biopsy findings reveal a high-grade osteosarcoma. Staging studies show that the tumor impinges on the neurovascular bundle. The tumor enlarges during preoperative chemotherapy. Management should now consist of
marginal excision, sparing the neurovascular bundle.
wide excision, including the neurovascular bundle.
What is the most common primary malignant bone or cartilage tumor in children?
Giant cell tumor