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Function after total calcanectomy for malignant tumor in a child: is complex reconstruction necessary?
V Madhuri1, B Balakumar, N M Walter
1Paediatric Orthopaedic Unit, Christian Medical College, Vellore, India. madhuriwalter@cmcvellore.ac.in
Summary
Complex reconstruction may not be necessary after calcaneal tumor excision in children. A 7-year-old achieved near-normal function after total calcanectomy for a primitive neuroectodermal tumor.
Area of Science:
- Pediatric Orthopedics
- Surgical Oncology
- Reconstructive Surgery
Background:
- Aggressive or malignant tumors of the calcaneum often necessitate surgical resection.
- Complex reconstruction techniques have been advocated following calcaneal excision to restore function.
- The optimal surgical approach and reconstruction strategy in pediatric cases remain debated.
Observation:
- A 7-year-old patient with a primitive neuroectodermal tumor of the calcaneum underwent total calcanectomy.
- The patient received neoadjuvant chemotherapy prior to surgical resection.
- The Cincinnati incision was utilized for the calcanectomy procedure.
Findings:
- The patient achieved near-normal functional outcomes following total calcanectomy without complex reconstruction.
- Specific gait abnormalities were observed and described post-operatively.
- This case suggests that extensive reconstruction may not be universally required in pediatric calcaneal tumor resections.
Implications:
- These findings challenge the routine need for complex reconstruction after calcaneal excision in pediatric oncology.
- The Cincinnati incision appears to be a beneficial approach for pediatric calcanectomy.
- Further research into gait patterns after tumor-related calcanectomy in children is warranted.
