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Rotationplasty with Tibial Nerve Coaptation: A Case Report
Solange de Wouters1,2, Alexander Thomas Schade1,3, Ali Etemad-Rezaie1
1Division of Orthopaedics, Hospital for Sick Children and University of Toronto, Ontario, Canada.
Case:
We present the case of a 14-year-old adolescent boy with a distal femoral osteosarcoma partially encasing the tibial nerve. He underwent rotationplasty with resection and coaptation (end-to-end repair) of the tibial nerve. By 1 year postoperatively, he had recovered sensation on the plantar aspect of his foot and Medical Research Council scale 4+/5 gastro-soleus contraction that powered extension of the new knee.
Conclusion:
Tibial nerve resection is not an absolute contraindication for rotationplasty, even in an adolescent. Nerve coaptation allows for well-functioning rotationplasty as an alternative to endoprosthetic reconstruction or above-knee amputation.
