Objective:To analyze the clinical features of limb salvage surgery with epiphyseal preservation in children and adolescents,and to evaluate the recurrence rate,metastasis,complications,and the joint functional results after tumor resection.Methods:Between Dec 1995 and Jan 2003,we operated on 33 patients aging from 8 to 16 years (average 12.18 years) with diagnosis of primary malignant bone tumor of the extremities preserving the epiphysis in the limb salvage surgery.In this group,the tumor located in distal femur in 24 cases and in proximal tibia in 9 cases.There were 23 osteosarcomas,6 Ewings tumors,2 chondrosarcomas,and 2 invasive osteoblastomas.The tumors were staged clinically.Among them,there were 2 cases in Ⅰ A,2 cases in Ⅰ B,17 cases inⅡ A,and 12 cases inlⅡ B.According to the relationship between the tumor and epiphyseal plate,the metaphyseal tumors in children were classified into 3 types:18 cases were categorized as type Ⅱ,13 as type Ⅱ,and 2 as type Ⅲ.The patients received 2~4 cycles of preoperative adjuvant chemotherapy,and another 6 cycles after surgery,the modified protocol T10 was taken.Serious bone defects after tumor resections were repaired with massive allograft bone transplantation,followed by internal fixation by intramedullary nails and cancellous screws.