Ewing's sarcoma of the ulna treated with sub-total resection and reconstruction using a non-vascularized, autogenous fibular graft and hernia mesh: A case report

Abstract

Ewing's sarcoma of the bone is the second most frequently occurring malignant bone tumor in children and adolescents. Ewing's sarcoma in the ulna are extremely rare. Thus, the surgical options for reconstruction of the elbow are limited and technically challenging. In the current study, a 29-year-old male with Ewing's sarcoma of the ulna was treated with a sub-total resection and reconstruction using a non-vascularized, autogenous fibular graft and hernia mesh. At the 2-year follow-up, the patient had returned to his previous occupation with no evidence of local recurrence or distant metastasis. The functional recovery was satisfactory, and the patient could perform active movement of the elbow from 0° to 135°, forearm pronation to 30°, supination to 85° and had full hand function. The grip power of the left hand was 36 kg, which was 86% of the contralateral side (42 kg).

Elbow reconstruction after excision of proximal ulna tumors: Challenges and solutions

“…Megas et al (12) reported 20-110 0 of elbow ROM with 40-30 0 of prono-supination at more than 2 years follow-up with non-vascularized fibula in a case of metastatic carcinoma. However, the outcomes were superior when part of the olecranon was saved, and fibular graft was used as intercalary grafts (14,15). Wang et al (14) reported elbow ROM of 0-135 0 with 30-85 0 of prono-supination after intercalary fibular autograft.…”

Pain Around Elbow: Not Always Tennis Elbow!

“…The main malignant bone tumors seen around the elbow are osteosarcoma, primary giant cell bone tumor, and Ewing sarcoma. (Wang and Lin, 2015). In our study, we presented a case of Ewing Sarcoma of 15-year-old female (Fig.…”

Ulnohumeral reconstruction with autogenous, nonvascularized, fibular graft for metastatic clear cell renal carcinoma of the proximal ulna: a case report

“…Reconstruction of the proximal ulna after wide tumor resection using a nonvascularized fibular autograft has been reported in only 3 patients 5, 7, 15. Goyal et al 5 treated a 15-year-old child with desmoplastic fibroma of the ulna, preserving the proximal half of the olecranon for firm fixation to the graft.…”

“…At 2 years of follow-up, the active ROM at the elbow was 40° to 130°. Similarly, Wang et al 15 performed a subtotal resection of the proximal ulna and subsequent reconstruction of the proximal portion of the intraosseous membrane with a hernia mesh in a 29-year-old patient with Ewing sarcoma. They reported an excellent functional outcome, with 0° to 135° elbow ROM and forearm pronation of 35° and supination of 85°at 2 years of follow-up.…”