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Salvage of foot with extensive giant cell tumour with transfer of vascularised fibular bone graft.

Tharayil J, Patil RK - Indian J Plast Surg (2011)

Bottom Line: After excision his foot was reconstructed with vascularised bone flap.Graft united early and showed excellent remodelling because of good vascularity.We feel that this method deserves consideration as a last attempt to salvage functional foot in disease like this.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Lakeshore Hospital, Cochin, India.

ABSTRACT
Though giant cell tumor is not uncommon in young adults, simultaneous involvement of multiple mid-foot bones is very uncommon and very difficult to treat. For reconstruction of large segmental bony defects following tumour excision, free vascularized bone graft is an excellent surgical option. We report a case with extensive involvement of all the tarsal bones and metatarsal bases in a young adult. After excision his foot was reconstructed with vascularised bone flap. We were able to save his foot after a wide local excision and reconstruction with free fibula graft. Graft united early and showed excellent remodelling because of good vascularity. We feel that this method deserves consideration as a last attempt to salvage functional foot in disease like this.

No MeSH data available.


Related in: MedlinePlus

Involvement of the tarsal bones and metatarsal bases. (a) Central part of the calcaneum and talus and (b) anterior parts of the talus and calcaneum
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Figure 4: Involvement of the tarsal bones and metatarsal bases. (a) Central part of the calcaneum and talus and (b) anterior parts of the talus and calcaneum

Mentions: The recurred lesion was a single diffuse swelling of 7 cm × 6 cm in size over the antero-medial aspect of the right mid-foot with a well-healed surgical scar over the centre of the swelling [Figure 1a]. There was no distal neurovascular deficit. After complete physical examination, radiographs and magnetic resonance (MR) imaging scan of the leg and foot were obtained. A fresh biopsy taken from the lateral aspect of the foot [Figure 1b] confirmed tumour recurrence. The radiograph of the foot showed confluent involvement of all tarsal bones and metatarsal bases [Figure 1c]. MR scan of the foot confirmed the skeletal involvement [Figure 2a and b]; and ruled out any soft tissue involvement.


Salvage of foot with extensive giant cell tumour with transfer of vascularised fibular bone graft.

Tharayil J, Patil RK - Indian J Plast Surg (2011)

Involvement of the tarsal bones and metatarsal bases. (a) Central part of the calcaneum and talus and (b) anterior parts of the talus and calcaneum
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3111110&req=5

Figure 4: Involvement of the tarsal bones and metatarsal bases. (a) Central part of the calcaneum and talus and (b) anterior parts of the talus and calcaneum
Mentions: The recurred lesion was a single diffuse swelling of 7 cm × 6 cm in size over the antero-medial aspect of the right mid-foot with a well-healed surgical scar over the centre of the swelling [Figure 1a]. There was no distal neurovascular deficit. After complete physical examination, radiographs and magnetic resonance (MR) imaging scan of the leg and foot were obtained. A fresh biopsy taken from the lateral aspect of the foot [Figure 1b] confirmed tumour recurrence. The radiograph of the foot showed confluent involvement of all tarsal bones and metatarsal bases [Figure 1c]. MR scan of the foot confirmed the skeletal involvement [Figure 2a and b]; and ruled out any soft tissue involvement.

Bottom Line: After excision his foot was reconstructed with vascularised bone flap.Graft united early and showed excellent remodelling because of good vascularity.We feel that this method deserves consideration as a last attempt to salvage functional foot in disease like this.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Lakeshore Hospital, Cochin, India.

ABSTRACT
Though giant cell tumor is not uncommon in young adults, simultaneous involvement of multiple mid-foot bones is very uncommon and very difficult to treat. For reconstruction of large segmental bony defects following tumour excision, free vascularized bone graft is an excellent surgical option. We report a case with extensive involvement of all the tarsal bones and metatarsal bases in a young adult. After excision his foot was reconstructed with vascularised bone flap. We were able to save his foot after a wide local excision and reconstruction with free fibula graft. Graft united early and showed excellent remodelling because of good vascularity. We feel that this method deserves consideration as a last attempt to salvage functional foot in disease like this.

No MeSH data available.


Related in: MedlinePlus