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Functional Elbow Reconstruction After Complete Ulnar Resection for Ewing's Sarcoma: Radial Neck Transposition as a

Fernando Brasil do Couto Filho1, Deivid Ramos Dos Santos2, Luiz Claudio Campelo Barbosa3

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Summary

Radial neck transposition offers a viable solution for elbow reconstruction after ulnar resection in Ewing

Keywords:
Ewing′s sarcomaelbow reconstructionlimb salvageorthopedic oncologyradial neck transposition

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Area of Science:

  • Orthopedic Surgery
  • Skeletal Oncology
  • Reconstructive Surgery

Background:

  • Ewing's sarcoma of the ulna is rare, necessitating complex surgical approaches.
  • Wide ulnar resection for tumors presents significant challenges in preserving upper limb function and elbow stability.
  • Conventional reconstruction methods have limitations and a high complication rate.

Purpose of the Study:

  • To report a novel case of elbow reconstruction following ulnar resection for Ewing's sarcoma.
  • To evaluate the functional outcomes of radial neck transposition to the humeral trochlea.
  • To assess the viability of this technique in preserving elbow joint stability and forearm mobility.

Main Methods:

  • A 17-year-old male patient with ulnar Ewing's sarcoma underwent complete ulnar resection.
  • Radial neck transposition to the humeral trochlea was performed for elbow reconstruction.
  • Functional outcomes were assessed using the Musculoskeletal Tumor Society (MSTS) scale, complemented by radiographic follow-up.

Main Results:

  • Two-year follow-up showed an MSTS score of 28/30, indicating good functional recovery.
  • The patient maintained preserved wrist and hand mobility, with full pronation and half of normal supination.
  • Radiographic evaluation confirmed proper alignment, stability, and absence of bone resorption.

Conclusions:

  • Radial neck transposition is a promising technique for elbow reconstruction after ulnar resection.
  • This method provides joint stability and functional limb preservation in cases of ulnar Ewing's sarcoma.
  • Further research with larger cohorts is warranted to confirm these findings.