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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

Lateral view at the same time
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Figure 12: Lateral view at the same time

Mentions: Three and half years after the reconstruction [Figure 5a and b], the patient is disease free and ambulatory with near-normal gait. He has normal sensation over the plantar and dorsal aspects of the foot. The ankle joint has 20 degrees of dorsiflexion and 10 degrees of plantar flexion. There is a flexion deformity at the metatarsophallangeal joints of all toes, and complete dorsiflexion of toes is not possible. This may be due to lax extensors that have shown no tendency to spontaneous adjustment in length or tension over the period of time. This can be easily corrected by adjusting the tension of extrinsic extensors of the toes but the patient is satisfied with the reconstruction and has refused the option of undergoing another surgery. According to Enneking's functional scoring system [Table 1] used for evaluation outcome following excision of extremity neoplasm, this patient scored 25/30 points. The patient has slight limp while walking. He does not have a high stepping gait neither does he sway to either side while walking.


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

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

Lateral view at the same time
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 12: Lateral view at the same time
Mentions: Three and half years after the reconstruction [Figure 5a and b], the patient is disease free and ambulatory with near-normal gait. He has normal sensation over the plantar and dorsal aspects of the foot. The ankle joint has 20 degrees of dorsiflexion and 10 degrees of plantar flexion. There is a flexion deformity at the metatarsophallangeal joints of all toes, and complete dorsiflexion of toes is not possible. This may be due to lax extensors that have shown no tendency to spontaneous adjustment in length or tension over the period of time. This can be easily corrected by adjusting the tension of extrinsic extensors of the toes but the patient is satisfied with the reconstruction and has refused the option of undergoing another surgery. According to Enneking's functional scoring system [Table 1] used for evaluation outcome following excision of extremity neoplasm, this patient scored 25/30 points. The patient has slight limp while walking. He does not have a high stepping gait neither does he sway to either side while walking.

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