Wahyudi Muhammad, Satria Oryza, Prawirodihardjo Bonita, Zulhandani Muhammad
Orthopaedic Oncology Consultant, Department of Orthopaedic and Traumatology, Fatmawati General Hospital Jakarta, Indonesia.
Hand and Microsurgery Consultant, Department of Orthopaedic and Traumatology, Fatmawati General Hospital Jakarta, Indonesia.
Int J Surg Case Rep. 2021 Oct;87:106414. doi: 10.1016/j.ijscr.2021.106414. Epub 2021 Sep 15.
Periosteal osteosarcoma is a rare type of primary bone tumor. A vascularized fibula graft incorporates this revolutionary approach with a traditional massive allograft to reconstruct large femur and tibia defects during oncological resection. A structurally competent reconstruction with improved vascular and osteogenic capacities with the ability to achieve lower rates of fracture, infection, and non-union is obtained by integrating the benefits of this separate components.
A 16-year-old female diagnosed with periosteal osteosarcoma of the left shaft femur. We performed neoadjuvant chemotherapy, limb salvage surgery consists of surgical resection and reconstruction, followed by adjuvant chemotherapy post operatively. We used the modified Capanna procedure to salvage the femur.
Post-operative evaluation showed stable fixation clinically and radiologically. There were no complications observed during recovery, as both distal motor and sensory are normal eventhough the patient were still limited in the motion of the hip and knee at the time due to post-operative pain.
Cappana procedure has been known as a novel surgical method that could decrease the risk of complications results from classic reconstruction method, such as fracture, non-union, and infection.
Modified Cappana procedure which introduce the use liquid nitorgen-recycled autograft from the resected affected bone as a peripheral shell supporting a centrally placed vascularized fibular graft to fill the massive bone defect left by surgical resection, had successfully performed in our patient whom previously diagnosed with periosteal osteosarcoma of femoral shaft.
骨膜骨肉瘤是一种罕见的原发性骨肿瘤。带血管的腓骨移植将这种革命性方法与传统的大块同种异体移植相结合，以在肿瘤切除术中重建大的股骨和胫骨缺损。通过整合这些独立组件的优势，可实现结构上有效的重建，具有改善的血管生成和成骨能力，能够降低骨折、感染和骨不连的发生率。
一名16岁女性被诊断为左股骨干骨膜骨肉瘤。我们进行了新辅助化疗，保肢手术包括手术切除和重建，随后进行术后辅助化疗。我们采用改良的卡帕纳手术来挽救股骨。
术后评估显示临床和影像学上固定稳定。恢复期间未观察到并发症，尽管由于术后疼痛，患者当时髋部和膝部的活动仍受限，但远端运动和感觉均正常。
卡帕纳手术是一种新型手术方法，可降低经典重建方法导致的并发症风险，如骨折、骨不连和感染。
改良的卡帕纳手术引入了使用液氮回收自切除的患骨的自体移植物作为外周壳，支撑置于中心位置的带血管腓骨移植物，以填充手术切除后留下的大块骨缺损，该手术已在我们先前诊断为股骨干骨膜骨肉瘤的患者中成功实施。
