Lateral malleolus en bloc resection for the distal fibula osteosarcoma based on a new classification and proposed reconstruction choice: Analysis of 6 cases prognosis and literature review

Wang, Jun; Du, Zhiye; Yang, Rongli; Tang, Xiaodong; Guo, Wei

doi:10.1016/j.fas.2019.11.003

Cited by 7 publications

(15 citation statements)

References 21 publications

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“…Reconstruction with distal fibular allografts has also been described (Jamshidi et al, 2013;Lubliner et al, 1985;Papagelopoulos et al, 2005;Perisano et al, 2012;Saadon et al, 2017;San-Julian et al, 2008;Wang et al, 2020). This is not indicated in children because the grafted fibula does not grow proportional to the tibia, and this would cause valgus deformity of the ankle.…”

Section: Discussionmentioning

confidence: 99%

“…Tibiotalar arthrodesis with screws, a hindfoot nail or bone grafts also achieves ankle stability (Papagelopoulos et al, 2005; Perisano et al, 2012; Saadon et al, 2017; Wang et al, 2020). However, it has several limitations, including the loss of ankle motion, a long period of recovery, and possible non‐union, especially in osteopenic bones (Papagelopoulos et al, 2005; Perisano et al, 2012; Saadon et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Wang et al recommend the management of similar defects with a non‐vascularized contralateral fibular autograft and an ankle arthrodesis (Wang et al, 2020). This leads, however, to a loss of ROM in the ankle and subtalar joint.…”

Section: Discussionmentioning

confidence: 99%

“…Given the rarity of this tumor location (Niimi et al, 2008), the literature regarding this matter is scarce. Classical options described include ligamentoplasties to the lateral tibia using the distal peroneal or tibialis tendons (Capanna et al, 1986; Dieckmann et al, 2011; Durak et al, 1996; Lamb et al, 2021; Marcove & Rosen, 1980; Monson et al, 2014; Papagelopoulos et al, 2005; Shoji et al, 1970; Vaseenon et al, 2017; Yadav, 1981), tibiotalar arthrodesis (Dieckmann et al, 2011; Ozaki et al, 1997; Papagelopoulos et al, 2005; Perisano et al, 2012; Saadon et al, 2017; Wang et al, 2020; Yin et al, 2015; Yoshida et al, 2017), fixation of the proximal fibula to the tibia (CARRELL, 1938; Persson & Rydholm, 1979), prosthethic ankle joint replacement (Papagelopoulos et al, 2005; Perisano et al, 2012), reconstruction with distal fibular allografts (Jamshidi et al, 2013; Lubliner et al, 1985; Papagelopoulos et al, 2005; Perisano et al, 2012; Saadon et al, 2017; San‐Julian et al, 2008; Wang et al, 2020), contralateral fibular autografts (Wang et al, 2020), iliac crest bone grafts (Eger et al, 2004; Papagelopoulos et al, 2005; Perisano et al, 2012), rotating the ipsilateral proximal fibula 180° (Capanna et al, 1986; Dieckmann et al, 2011; Papagelopoulos et al, 2005; Perisano et al, 2012; Saadon et al, 2017; Wang et al, 2020), and pedicled or free fibular flaps (Bibbo et al, 2015; Cavadas & Thione, 2015; de Gauzy et al, 2002; Gao et al, 2016; Panuel et al, 1997; Papagelopoulos et al, 2005; Rajacic & Dashti, 1996). Furthermore, there are case series in young patients in which no ankle reconstruction was performed, wit...…”

Section: Introductionmentioning

confidence: 99%

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Ankle joint salvage surgery with an ipsilateral mid‐fibula osteocutaneous free flap and contralateral anterolateral thigh free flap: A case report and literature review

et al. 2022

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The tibiofibular joint can be reconstructed after distal fibular sarcoma salvage surgery to maintain ankle stability and achieve early gait. Classical reconstructive options include ligamentoplasties, arthrodesis, prosthetic replacement, bone grafts, and pedicled ipsilateral or free contralateral fibular bone flaps. We present a novel strategy for reconstruction of the ankle in an elderly patient and a literature review. A 68-year-old man presented with a high-grade myxofibrosarcoma to his distal fibula.Wide resection of the tumor and adjacent structures left a 12 Â 12 Â 8 cm defect including the distal fibula (10 cm), a 2 cm fragment of the lateral cortex of the tibia, the lateral anterior and superficial posterior compartments, and the lateral compartment. A 3 cm distal fibula remnant was left in the ankle mortice. Reconstruction was performed using a free ipsilateral 13-cm diaphyseal osteocutaneous fibular flap telescoped into the distal fibula remnant and anastomosed to the anterior tibial artery. A pre-bent L-shaped locking plate was used to reconstruct a syndesmotic joint. A 21 Â 13 cm suprafascial ALT flap was anastomosed to the proximal stump of the peroneal artery to cover the soft tissue defect. The patient had no complications and was ambulating with full weight bearing by postoperative week 11. He received postoperative chemo and radiotherapy. Three years postoperatively, he is tumor free, has complete ankle ROM and stability, and ambulates with no restrictions. Limb sparing surgery with a functional tibiofibular joint reconstruction should be considered to attain an early functional recovery after distal fibula sarcomas resection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ankle joint salvage surgery with an ipsilateral mid‐fibula osteocutaneous free flap and contralateral anterolateral thigh free flap: A case report and literature review

et al. 2022

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“…In a case series, Jamshidi et al suggested that reconstruction of distal fibula with osteoarticular allograft after tumor resection could achieve bony union with the mean time of 12 months and full ankle function except asymptomatic valgus deformity in one patient 8 . Additionally, primary ankle arthrodesis and prosthetic ankle replacement were feasible in limb salvage for treatment of distal intraarticular tibial tumors 9,10 . Nevertheless, these techniques were not available in pediatric reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Lateral Malleolus Reconstruction After Tumor Resection in Children: A Case Report and Literature Review

Long

Chen

et al. 2022

Orthopaedic Surgery

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Background Pediatric reconstruction of lateral malleolus was necessary and challengeable. Up to now, vascularized fibular was the optimal graft to reconstruct epiphyseal defection. However, the sophisticated microvascular operation has limited the wide application of this technique. Case Presentation We present the case of a 9‐year‐old boy with Ewing sarcoma in left distal fibula. In order to restore the growth capacity, we used reverse‐flow vascularized fibular epiphyseal graft with tibialis anterior artery to reconstruct the bone defect after tumor resection with no microvascular anastomosis. More than 4 years after the operation and adjuvant chemotherapy, the patient was free of pain and recurrence, and the function and stability of ankle joint was perfect. Radiology examination revealed satisfied bony union of fibula and normal growth of the fibular head transplant. Conclusions The advantage of reverse‐flow vascularized fibular epiphyseal graft is requiring no microvascular anastomosis which could not only shorten operating time, but also reduce factitious damage of vessels. This report presented that this technique might be an available option for reconstruction of lateral malleolus in children.

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Management of a rare giant cell tumor of the distal fibula: A case report

Fan¹,

Long²,

Wu³

et al. 2023

World J Clin Cases

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BACKGROUND Aggressive giant cell tumor of the distal fibula is so rare that no consensus on a surgical strategy has been reached. Thus, an appropriate treatment strategy is still important to discuss. CASE SUMMARY A 61-year-old man who had been experiencing progressive swelling of the left lateral malleolus accompanied by pain for half a year was presented at our hospital. He had never been treated prior to coming to our hospital. Preoperative imaging revealed a 10 cm × 6 cm mass located in the body of the distal fibula. Pathological biopsies confirmed it was a giant cell tumor. Preoperative examination revealed he had dilated cardiomyopathy with class 3 cardiac function. The cardiologist and anesthesiologist determined that he could tolerate the operation, but the operation should be as short and minimally invasive as possible. With the patient’s consent, we performed a tibiotalar fusion and followed up with him for 2 years, finding no recurrence and a satisfactory recovery. CONCLUSION Tibial talus fusion is an effective method for the treatment of distal fibula tumors.

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Lateral malleolus en bloc resection for the distal fibula osteosarcoma based on a new classification and proposed reconstruction choice: Analysis of 6 cases prognosis and literature review

Cited by 7 publications

References 21 publications

Ankle joint salvage surgery with an ipsilateral mid‐fibula osteocutaneous free flap and contralateral anterolateral thigh free flap: A case report and literature review

Ankle joint salvage surgery with an ipsilateral mid‐fibula osteocutaneous free flap and contralateral anterolateral thigh free flap: A case report and literature review

Lateral Malleolus Reconstruction After Tumor Resection in Children: A Case Report and Literature Review

Management of a rare giant cell tumor of the distal fibula: A case report

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