In the Enneking system of surgical margins, a 'radical' margin for an osteosarcoma of the mid-diaphysis of the femur means:

• A Removal of the tumour shell through its pseudocapsule
• B Removal of the tumour together with a cuff of normal tissue in all planes
• C Removal of the entire anatomical compartment containing the tumour, such as the whole femur ✓
• D Removal of the tumour with the involved joint disarticulated

Explanation

Margins are graded intralesional (through the tumour), marginal (through the reactive zone or pseudocapsule), wide (through normal tissue outside the reactive zone) and radical (removal of the entire compartment harbouring the tumour). For a femoral diaphyseal osteosarcoma the relevant compartment is the bone, so a radical margin means resection of the whole femur. A cuff of healthy tissue defines a wide margin, not a radical one.

Reference: Campbell's Operative Orthopaedics, 14th ed.

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