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Modified Borggreve-Van Nes-Winkelmann rotationplasty for surgery in developing countries.

Laura Sommerauer1, Aung Phyo2, Eric Pion3

  • 1Centre of Plastic, Aesthetic, Hand and Reconstructive Surgery, Clinic Traunstein, Traunstein, Germany.

BMC Surgery
|September 7, 2022
PubMed
Summary

A modified Borggreve-Van Nes-Winkelmann rotationplasty offers a safe and effective limb salvage option for osteosarcoma patients in resource-limited settings. This technique proves successful in improving functional and aesthetic outcomes, reducing amputation rates.

Keywords:
Orthopedic surgeryPlastic surgeryReconstructive surgical procedureSurgical oncology

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Area of Science:

  • Orthopaedic Surgery
  • Surgical Oncology
  • Limb Reconstruction

Background:

  • Amputation remains the primary treatment for osteosarcoma in Myanmar, despite limb salvage surgery being the current standard.
  • Complex procedures like rotationplasty require safe and reliable techniques, especially in lower-middle income economies with limited resources.

Purpose of the Study:

  • To present seven cases of Borggreve-Van Nes-Winkelmann rotationplasty for osteosarcoma in Myanmar.
  • To evaluate the safety and sustainability of a modified rotationplasty technique in a resource-limited setting.

Main Methods:

  • Seven young patients with distal femur or proximal tibia osteosarcomas underwent modified Borggreve-Van Nes-Winkelmann rotationplasty.
  • Modifications included dissection and clamping of the femoral artery to minimize blood loss and creating an adipocutaneous flap to reduce swelling and pressure on vessels.

Main Results:

  • All seven patients achieved good functional and aesthetic outcomes.
  • One patient required secondary wound closure due to wound dehiscence.

Conclusions:

  • A simplified and safe Borggreve-Van Nes-Winkelmann rotationplasty technique was successfully adapted for lower-middle income economies.
  • The modified procedure proved feasible and effective under challenging resource constraints.