Lateral manus translation for limb‐sparing surgery in 18 dogs with distal radial osteosarcoma in dogs

Abstract

Objective: To describe and report outcomes after lateral translation of the manus for limb-sparing management of distal radial osteosarcoma in dogs. Study design: Retrospective case series. Study population: Eighteen client-owned dogs. Methods: The distal aspect of the affected radius and associated neoplastic tissues were excised. The distal aspect of the ulna was preserved except for its medial cortex, which was removed en bloc with the radial segment. The manus was translated laterally to place the radial carpal bone in contact with the distal aspect of the ulna. A limb-sparing or locking compression plate was placed on the remaining proximal radius and the 3rd metacarpal bone. A 3.5-mm SOP (string of pearls) plate was placed on the lateral aspect of the proximal ulna and the 4th metacarpal bone. Dogs were administered chemotherapy. Data were collected to assess surgical and oncologic outcomes. Limb function was subjectively assessed. Results: The percentage of radius removed ranged from 43% to 94% (median 54%). Complications developed in 12 limbs, with infection in 10, biomechanical complications in 6, and local recurrence in 4. Limb function was subjectively assessed as acceptable. Median disease-free interval was 219 days, and median survival time was 370 days. Conclusion: Outcomes after lateral translation of the manus compared favorably to other limb-sparing techniques for dogs with distal radial osteosarcoma, particularly in dogs requiring excision of a large segment of the radius. Clinical significance: The lateral manus translation provides an alternative limbsparing technique that does not require an allograft, endoprosthesis, or autograft.

Iliectomy with limb preservation for a dog with ilial osteosarcoma: Surgical description and case report

“…While limb‐sparing surgery for appendicular osteosarcoma is typically described with approximately 3‐cm margins proximal to the gross extent of the lesion, the superficial dissection is marginal. Despite this, recurrence rates are relatively low at 7% to 25% . Conventional wide margins did not seem feasible for this dog, even with partial sacrectomy and external hemipelvectomy.…”

Limb‐sparing in dogs using patient‐specific, three‐dimensional‐printed endoprosthesis for distal radial osteosarcoma: A pilot study

“…It is unknown if the curving of the skin incision laterally at the proximal aspect was a factor by potentially disrupting vascular supply to this area of the skin. An identical approach was performed in 18 dogs for the lateral manus translation technique and none had this complication . Other factors that may be at cause are the morbidity created by the placement of the catheter for the IA chemotherapy or the IA chemotherapy itself.…”

“…Local recurrence occurred in one dog. Local recurrence following complete histological resection has been reported in 4% to 30% of dogs after limb‐sparing surgery of the distal radius …”

“…In this dog, the endoprosthesis was also fixed to the proximolateral surface of the ulna (Figure ). To accommodate implantation of this endoprosthesis, the approach was identical to that utilized for the lateral manus translation, where the skin incision at the proximal aspect of the antebrachium is deviated on the lateral aspect . The ulnar osteotomy was performed more distally than the radial osteotomy, immediately distal to the interosseous ligament.…”

“…Treatment alternatives in the curative‐intent setting include surgical limb‐sparing and stereotactic radiation therapy (SRT). Limb‐sparing is most commonly performed for OSA located in the distal radius . Many techniques have been described for this anatomic site: cortical allograft, stainless steel endoprosthesis, distraction osteogenesis by bone transport, intraoperative extracorporeal radiotherapy, tumoral autograft pasteurization, microvascular ulnar autograft, ulnar rollover transposition, limb shortening, lateral manus translation, and patient‐specific, three‐dimensional (3D)‐printed endoprosthesis …”