Plate-assisted bone segment transport: Novel application on distal tibia defect after tumour resection. A case report

Area of Science:

• Orthopedic oncology
• Limb salvage surgery
• Bone reconstruction techniques

Background:

• Reconstructing large distal tibia bone defects post-limb salvage surgery presents significant challenges.
• Current options include endoprosthetic replacement, arthrodesis, and intercalary reconstructions, each with limitations.
• A novel technique is presented to achieve long-lasting biological reconstruction while preserving the native ankle.

Purpose of the Study:

• To introduce and evaluate the efficacy of Plate-assisted bone segment transport (PABST) for distal tibia reconstruction.
• To demonstrate a method for biological reconstruction that preserves the native ankle joint.
• To report the outcomes of PABST in a patient with distal tibia osteosarcoma.

Main Methods:

• A case study of a 47-year-old male with distal tibia osteosarcoma is presented.
• Following neoadjuvant chemotherapy and wide excision preserving the ankle joint, reconstruction was performed using PABST with a non-invasive growing intramedullary nail.
• Follow-up included assessment of bone union and functional outcomes using the Musculoskeletal Tumour Society Score.

Main Results:

• Solid bone union was achieved at 34 months post-surgery.
• The patient achieved a high Musculoskeletal Tumour Society Score of 26/30.
• Regenerate formation was successful despite the use of adjuvant chemotherapy.

Conclusions:

• Plate-assisted bone segment transport (PABST) is reported as a viable and safe method for reconstructing large bone defects after distal tibia tumor resection.
• This technique successfully facilitates biological reconstruction and preserves the native ankle.
• PABST represents a valuable addition to the surgical options for complex bone defect management.