Epiphyseal fibula transfer to proximal humerus following resection for osteosarcoma surgical technique
Learn the Epiphyseal fibula transfer to proximal humerus following resection for osteosarcoma surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Epiphyseal fibula transfer to proximal humerus following resection for osteosarcoma surgical procedure.
The proximal humerus is the fourth most common site for primary bone sarcomas, with up to 15% of osteosarcomas and 10% of Ewing’s sarcomas occurring at this site. Preserving growth and function following limb-salvage surgery in paediatric patients remains a challenge, as the proximal humeral physeal growth is responsible for 80% of the total growth of the humerus, and loss of one of the physes is associated with limb-length discrepancy. This is particularly challenging in small children in whom endoprosthetic replacements are often too large and expandable prostheses have higher rates of complications compared with adults.
Vascularised autografts may provide rapid biological incorporation with the potential for growth and a limb-salvage reconstruction with longevity.
Vascularised fibular epiphyseal transfer preserves function and growth in young children following excision of the proximal humerus for a malignant bone tumour. Function compares favourably to other limb-salvage procedures in children. Failures are caused by avascular necrosis of the graft but the reported survival of the reconstruction is 82% at five years.
Author: Mr Jonathan Stevenson FRCS (Tr & Orth)
Institution: The Royal Orthopaedic Hospital ,Birmingham ,UK.
- Each operation and the questions associated become named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
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- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
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Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
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