Nobuyuki Sasaki1, Ryoichi Kawakami1,2,3, Narihiro Toshiki1,4, Hitoshi Yamada1,5, Michiyuki Hakozaki1,6, Shin-Ichi Konno1. 1. Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan. 2. Department of Traumatology and Reconstructive Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan. 3. Kawakami Orthopaedic Clinic, Fukushima, Japan. 4. Department of Hand and Limb Reconstructive Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan. 5. Department of Musculoskeletal Oncology and Metabolic Bone Disease Research, Fukushima Medical University School of Medicine, Fukushima, Japan. 6. Higashi-Shirakawa Orthopaedic Academy, Fukushima Medical University School of Medicine, Fukushima, Japan.
Abstract
BACKGROUND: Recent progress in the chemotherapy and surgical procedures for osteosarcoma have enabled the preservation of limb function even when cancer occurs in the distal radius, a rare primary site of osteosarcoma. CASE REPORT: We describe a case of osteosarcoma that occurred in an 18-year-old, male Kyudo (Japanese archery) archer's left distal radius. Since the patient desired to resume Kyudo and the left hand was quite important for gripping a bow, we chose partial wrist arthrodesis (fibulo-scapho-lunate arthrodesis) with free vascularized fibular grafting (FVFG) as the reconstruction procedure following wide resection. After the wide resection, the major axis of bone defect was 8 cm. We harvested a free vascularized fibular graft with fascio-cutaneous flap with wide fascia to reconstruct the gliding surface of the extensor tendon. Fibula-proximal radius and fibulo-scapho-lunate fixation was performed by locking plates individually. Vascular anastomosis was performed between the radial artery and peroneal artery in a flow-through manner. Two peroneal veins were anastomosed with the radial vein and cephalic vein. CONCLUSION: Fibulo-scapho-lunate arthrodesis with FVFG may provide satisfied stability and function even in a Kyudo archer. The patient obtained sufficient wrist stability and grip strength, and could resume Kyudo. Copyright 2022, International Institute of Anticancer Research.
BACKGROUND: Recent progress in the chemotherapy and surgical procedures for osteosarcoma have enabled the preservation of limb function even when cancer occurs in the distal radius, a rare primary site of osteosarcoma. CASE REPORT: We describe a case of osteosarcoma that occurred in an 18-year-old, male Kyudo (Japanese archery) archer's left distal radius. Since the patient desired to resume Kyudo and the left hand was quite important for gripping a bow, we chose partial wrist arthrodesis (fibulo-scapho-lunate arthrodesis) with free vascularized fibular grafting (FVFG) as the reconstruction procedure following wide resection. After the wide resection, the major axis of bone defect was 8 cm. We harvested a free vascularized fibular graft with fascio-cutaneous flap with wide fascia to reconstruct the gliding surface of the extensor tendon. Fibula-proximal radius and fibulo-scapho-lunate fixation was performed by locking plates individually. Vascular anastomosis was performed between the radial artery and peroneal artery in a flow-through manner. Two peroneal veins were anastomosed with the radial vein and cephalic vein. CONCLUSION: Fibulo-scapho-lunate arthrodesis with FVFG may provide satisfied stability and function even in a Kyudo archer. The patient obtained sufficient wrist stability and grip strength, and could resume Kyudo. Copyright 2022, International Institute of Anticancer Research.
Authors: Paul W Clarkson; Kelly Sandford; Amy E Phillips; Theresa J C Pazionis; Anthony Griffin; Jay S Wunder; Peter C Ferguson; Bassam A Masri; Thomas Goetz Journal: J Hand Surg Am Date: 2013-02-27 Impact factor: 2.230