Elbow Reconstruction Following an Extensive Resection of the Proximal Part of the Ulna in a Patient with Ewing Sarcoma

Sułko, Jerzy

doi:10.2106/jbjs.cc.l.00003

Cited by 6 publications

(10 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This may be difficult to achieve if the total ulna is excised [27]. In this case, another similar type of surgical procedure was reported [28], which consisted of radius neck-to-humerus trochlea transposition and an inverted V-plasty of the triceps brachii muscle was attached in to an opening created in the center of the radial head.…”

Section: Discussionmentioning

confidence: 93%

“…Although there have been reports of osteochondroma primary giant cell tumors and Ewing's sarcoma of the ulna. Salvaging the limb following an ulnar tumor resection poses a complex reconstructive challenge [8][9][10][11] options include resection arthroplasty, arthrodesis, resection-replantation [12], autografts [13,14], allografts [15], endoprostheses and radius neck-to-humerus trochlea transposition. Windrager and et al Recommend resection-replantation, in wich the tumor-bearing area is resected as a cylindrical segment and the distal arm is replanted with shortening [12].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A New Biological Technique of Elbow Reconstruction Following an Extensive Tumoral Resection of the Proximal Ulna

Sboui¹,

Jlalia²,

Riahi³

et al. 2017

Med Case Rep

View full text Add to dashboard Cite

The resection of malignant tumors often poses the challenge of reconstruction. The objective of this reconstruction is the restoration of a function. We present the case of a chondroblastic osteosarcoma of the ulna in a 27-year-old patient. The resection sacrificed part of the ulna. The conservation of part of the olecrane allowed an innovative reconstruction to be carried out by bringing the radial head into contact with the humeral trochlea. The preservation of elbow function was satisfactory.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

A New Biological Technique of Elbow Reconstruction Following an Extensive Tumoral Resection of the Proximal Ulna

Sboui¹,

Jlalia²,

Riahi³

et al. 2017

Med Case Rep

View full text Add to dashboard Cite

show abstract

“…Salvaging the limb following an ulnar tumor resection poses a complex, reconstructive challenge ( 6 , 7 , 9 – 11 ). Various options have been reported for the reconstruction of the elbow joint following ulnar tumor resections, such as radius neck-to-humerus trochlea transposition, endoprosthetic reconstruction, allografts, vascularized fibular grafts and extracorporeal irradiation ( 6 , 7 , 9 , 10 ). Due to the location of the tumors, previous studies primarily involved reconstructions of partial ulna defects, and the remnant ulna provided the basis for bone grafts or prosthesis implantation.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the present patient presented a unique surgical challenge. Sułko ( 6 ) reported a patient with Ewing's sarcoma who underwent radius neck-to-humerus trochlea transposition following an extensive resection of the proximal portion of the ulna. The technique of radius neck-to-humerus trochlea transposition was a good candidate for reconstruction of the elbow joint following wide resection of the ulna.…”

Section: Discussionmentioning

confidence: 99%

Ewing's sarcoma of the ulna treated with sub-total resection and reconstruction using a non-vascularized, autogenous fibular graft and hernia mesh: A case report

Lin

2015

Oncology Letters

View full text Add to dashboard Cite

Ewing's sarcoma of the bone is the second most frequently occurring malignant bone tumor in children and adolescents. Ewing's sarcoma in the ulna are extremely rare. Thus, the surgical options for reconstruction of the elbow are limited and technically challenging. In the current study, a 29-year-old male with Ewing's sarcoma of the ulna was treated with a sub-total resection and reconstruction using a non-vascularized, autogenous fibular graft and hernia mesh. At the 2-year follow-up, the patient had returned to his previous occupation with no evidence of local recurrence or distant metastasis. The functional recovery was satisfactory, and the patient could perform active movement of the elbow from 0° to 135°, forearm pronation to 30°, supination to 85° and had full hand function. The grip power of the left hand was 36 kg, which was 86% of the contralateral side (42 kg).

show abstract

“…However, the greater challenge lies in reconstruction of the complex interplay between the multiple joints around the elbow for stability and function. Several techniques of reconstruction have been described, including radial head transposition [2–5], fibular autografts [6, 7], allograft with internal fixation, and endoprostheses [8–10]. However, these procedures are associated with complications and deficient in resulting in a stable functional joint.…”

Section: Introductionmentioning

confidence: 99%

Reconstructive Challenges of Proximal Ulnar Bone Tumors: Our Experience with Biological Osteoarticular Reconstruction Using Extracorporeal Irradiation and Reimplantation

Gundavda

Agarwal

Reddy

2019

Sarcoma

View full text Add to dashboard Cite

Introduction. Limb salvage surgery following proximal ulna resection poses a challenge in reconstruction of the complex elbow anatomy. Various reconstruction methods described offer inadequate restoration of function and stability. Following resection of proximal ulna tumors, we aimed to restore the joint using the resected osteochondral segment of proximal ulna treated with extracorporeal irradiation and reimplantation. Questions/Purposes. (1) Does irradiated osteoarticular autograft reconstruction for proximal ulna allow anatomical joint restoration and what are the oncological and functional outcomes? (2) Is there evidence of graft-related complications or osteoarthritis at a minimum of 2 years follow-up with irradiated osteoarticular autografts for the proximal ulna? (3) How does our method of reconstruction fare as compared to reported reconstruction options in the literature? Materials and Methods. 3 patients with primary bone tumors involving the proximal ulna underwent limb salvage surgery with en bloc resection and reconstruction using the resected bone after treating it with extracorporeal irradiation of 50 Gy. Minimum follow-up of 2 years was considered for assessment of final outcomes. Radiographs were assessed for bony recurrence, union across osteotomy junction, and signs of joint arthritis. Functional outcome measures included range of movement, muscle power testing, and functional and disability scores. Results. 2 complete and 1 partial olecranon involving proximal ulnar resections were performed for three cases of Ewing’s sarcoma in 2 males and 1 female. Follow-up ranged from 28 to 42 months, and all patients continue to remain disease free. All 3 patients have achieved full range of flexion-extension and pronosupination movement in comparison to the contralateral side. Muscle power for flexion and extension was 5/5. MSTS score: 100% (30/30); MEPS score: 100; and DASH score: zero were achieved for all patients. Union across osteotomy junctions at median follow-up of 8 months without need for intervention/bone grafting was achieved. No complications related to joint laxity/subluxation, infection, graft fracture, or implant failure was noted. None of the patients have clinical or radiological signs of joint arthritis across the irradiated articulation. Conclusion. Biological restoration of elbow anatomy using osteoarticular irradiated graft for proximal ulna reconstruction offers great joint stability and functional outcomes. Although the potential risks of infection and graft failure need to be considered, reconstruction with the size-matched radiated autograft eliminates donor site morbidity, offers a low-cost alternative to endoprosthesis, and provides outcomes superior to any other methods of reconstruction as analyzed from the literature.

show abstract

Elbow Reconstruction Following an Extensive Resection of the Proximal Part of the Ulna in a Patient with Ewing Sarcoma

Cited by 6 publications

References 7 publications

A New Biological Technique of Elbow Reconstruction Following an Extensive Tumoral Resection of the Proximal Ulna

A New Biological Technique of Elbow Reconstruction Following an Extensive Tumoral Resection of the Proximal Ulna

Ewing's sarcoma of the ulna treated with sub-total resection and reconstruction using a non-vascularized, autogenous fibular graft and hernia mesh: A case report

Reconstructive Challenges of Proximal Ulnar Bone Tumors: Our Experience with Biological Osteoarticular Reconstruction Using Extracorporeal Irradiation and Reimplantation

Contact Info

Product

Resources

About