Rotationplasty for Unplanned Fixation of Pathological Fracture Distal Femoral Osteosarcoma

Case Reports in Orthopedics
Chindanai HongsaprabhasChris Charoenlap

Abstract

Rotationplasty had been reported as a salvage procedure for many decades. However, this procedure has not been used for unplanned fixation for pathological fracture of osteosarcoma. Therefore, this is the first case report of rotationplasty for this particular indication. Case Presentation. We report a case of a 22-year-old Thai female patient who sustained a supracondylar fracture at the distal femur and underwent a surgical treatment by open reduction and internal fixation with a distal femoral locking plate and screws. Follow-up radiographic imaging revealed that there were abnormal osteolytic lesions, and conventional high-grade osteosarcoma was diagnosed by a pathological study. There were no distant metastases from Computed Tomography (CT) scan or Technitium-99m bone scintography. After discussing with the patient for treatment options, rotationplasty was chosen for her definitive treatment after 3 courses of neoadjuvant chemotherapy. All of the contaminated tissues were removed during the surgery. The neurovascular bundles were preserved. A standard rotationplasty type A-1 according to the Winkelmann Classification was performed. Postoperative imaging showed satisfactory outcomes, and the wound healed uneventfully. The p...Continue Reading

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