Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Indonesia; Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia, Persahabatan General Hospital, Indonesia
Erwin, U.S., Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Indonesia; Cahyadi, S.D., Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia, Persahabatan General Hospital, Indonesia
Introduction: Osteosarcoma is the second most common malignant bone tumor. The humerus is the third most common anatomical location for osteosarcoma, however, osteosarcoma around the elbow joint is uncommon. The intricacy of the elbow joint, limited soft tissue coverage, and proximity to nerves and arteries make the surgical resection and reconstruction complicated. Case report: A 17-year-old boy came with a chief complaint of lump and pain on his left elbow. One month later, the patient felt there was a lump with a size of a marble on the left elbow, which getting bigger to a size of a tenis ball. Physical examination showed mass on the posterior aspect of the elbow with the size 14x12cm. Plain radiographs revealed osteolytic lesion and periosteal reaction of the distal humerus and the magnetic resonance imaging (MRI) showed a low intensity on T2-weighted imaging. Histopathological examination suggested osteosarcoma. The patient underwent neoadjuvant chemotherapy for 3 cycles. The patient was treated with limb salvage surgery by wide excision, cryosurgery followed by total elbow arthroplasty and ORIF with plate and screw. Postoperative plain radiographs showed the plate and screws are well-fixated. The patient can slowly regain his elbow motion without limitation one month postoperatively. Conclusions: Distal humerus in an unusual site for osteosarcoma. Total elbow arthroplasty and ORIF with plate and screw is a favorable reconstruction option for distal humerus osteosarcoma with excellent postoperative functional outcomes. ? 2021 The Authors
Distal humerus; Osteosarcoma; Total elbow arthroplasty
cisplatin; doxorubicin; ifosfamide; liquid nitrogen; adolescent; arthralgia; Article; bone atrophy; bone radiography; case report; clinical article; computer assisted tomography; debridement; distal humerus; elbow arthroplasty; general anesthesia; histopathology; human; joint radiography; limb salvage; male; multiple cycle treatment; neoadjuvant chemotherapy; nuclear magnetic resonance imaging; osteosarcoma; osteotomy; periosteum; physical examination; postoperative care; radial artery; radial nerve; range of motion; reconstructive surgery; room temperature; total arthroplasty; ulnar nerve