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ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2007, Number 5

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Acta Ortop Mex 2007; 21 (5)

Distal tibial reconstruction and ankle arthrodesis in osteosarcoma (Salvage technique). A case presentation

Enríquez CJA, Hernández M, Cedillo SA, Molina MJ, Macías CCR

Language: Spanish
References: 19
Page: 289-295
PDF size: 252.97 Kb.


ABSTRACT

Treatment of bone sarcomas is aimed in healing and secondarily rescuing the limb. With the use of chemotherapy, radiation therapy, new prostheses and availability of graft, now most tumors can be resected, reducing functional deficit. Objective: To present a surgical option in management of osteosarcoma of distal tibia. Case report: Fifteen year-old man, starting in April 2003 with a mass in the left ankle area. June 2003 pulsatile progressive pain started, increased with activity, decreased with rest. November 2003 the physical exam: limping by left lower limb, with a tumor in the posteromedial ankle surface (3 x 2 cm), hard, not movable, regular edges, painful on palpation, Radiographic observations (November 2003), showed blastic oval stone image (4 x 3.5 cm) with expanded posterior and medial cortices with periosteal reaction. The initial biopsy report (chondroblastoma) was not consistent with the diagnostical assumption. So resection was performed 10 cm wide, placing a methylmethacrylate spacer. The final histological report was positive to osteogenic sarcoma. The patient received 11 sessions of chemotherapy. The reconstruction of the distal tibia and arthrodesis with autologous graft from the fibula, heterologous graft and stabilization with transcalcaneal nail, was done in March 2005. Results: Successful evolution without tumor activity with graft integration to arthrodesis and plantigrade gait.


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