Temporal hemiarthroplasty for distal femoral osteosarcoma in early childhood: a case report
- PDF / 1,499,496 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 42 Downloads / 169 Views
(2020) 18:280
CASE REPORT
Open Access
Temporal hemiarthroplasty for distal femoral osteosarcoma in early childhood: a case report Jungo Imanishi1,2,3* , Masayuki Tanabe1,4, Taisei Kurihara1, Tomoaki Torigoe1, Jun Kikkawa2,5, Atsuhiko Ohta6, Atsuko Watanabe6, Ryuhei Tanaka6, Kazuo Saita4, Yuho Kadono2 and Yasuo Yazawa1
Abstract Background: Prosthetic reconstruction for distal femoral osteosarcoma is challenging for younger children. We herein report a successful case of limb-sparing surgery for a younger patient with distal femoral osteosarcoma requiring osteo-articular resection. Case presentation: A 5-year-old girl with high-grade conventional osteosarcoma in the left distal femur underwent a series of surgeries. After three cycles of neoadjuvant chemotherapy, limb-salvage surgery was planned because femoral rotationplasty had been refused. At 6 years and 2 months old, distal femoral resection and temporary spacer insertion using a 7-mm-diameter intramedullary nail and molded polymethylmethacrylate was performed. At 7 years and 8 months old, secondary surgery was performed because the first spacer had been dislocated and the residual femur became atrophic. The distal end of the residual femur was removed by 1 cm, but the periosteum and induced membrane around polymethylmethacrylate was preserved. In order to stabilize the spacer against the tibia, a custom-made ceramic spacer with a smooth straight 8-mm-diameter stem was utilized. The bone-spacer junction was fixed with polymethylmethacrylate and then covered with the preserved periosteum and induced membrane. After surgery, the bone atrophy improved. At 9 years and 7 months old, the second spacer was removed because it had loosened, and the knee joint was reconstructed using a custom-made growing femoral prosthesis with a curved porous 8.5-mm-diameter stem. Cancellous bone tips from the proximal tibia were grafted around the bone-prosthesis junction underneath the induced membrane. At 10 years and 5 months old, the patient was able to walk unsupported and a radiograph showed further thickening of the cortex of the residual femur without any stress shielding. Although having 5 cm of limb length discrepancy, the patient and her mother were satisfied with the function. The MSTS score was 24 out of 30 points. Repeated limb length extensions are planned. (Continued on next page)
* Correspondence: [email protected]; [email protected] 1 Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 3501298, Japan 2 Department of Orthopaedic Surgery, Saitama Medical University Hospital, 38 Moro-hongo, Moroyama, Saitama 3500495, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original autho
Data Loading...
