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Is bone lengthening over an intramedullary prosthesis stem possible and safe?
Elie Romanos1, Ismat Ghanem, Fernand Dagher
1Hôtel-Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon.
Tibial lengthening over a prosthesis stem in a pediatric osteosarcoma patient achieved 5 cm bone growth but resulted in infection and prosthesis removal. This limb lengthening technique is not recommended due to high infection risks.
Area of Science:
- Orthopedic surgery
- Pediatric oncology
- Biomedical engineering
Background:
- A 13-year-old girl underwent left knee arthroplasty for proximal tibial osteosarcoma, resulting in leg length discrepancy.
- Epiphysiodesis of the contralateral limb was refused due to the patient's short stature.
Observation:
- Tibial lengthening over the prosthesis stem was performed using an Ilizarov apparatus.
- This procedure successfully generated 5 cm of good quality bone regenerate.
Findings:
- A secondary infection occurred, necessitating the removal of the prosthesis.
- This case represents a novel approach to limb length equalization in complex pediatric orthopedic oncology.
Implications:
- While bone lengthening was achieved, the high risk of secondary infection makes this technique inadvisable.
- Further research is needed to explore safer alternatives for limb length equalization in similar complex cases.
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