Bone
fracture
A 32 year old male fell off his bike and
sustained a fracture to his leg bone (Tibia). His fracture had multiple pieces
and his bone was plated (see post op x-ray).
Artificial bone is now available and was
used to fill defects in his bone. He was without any plaster from day one! He
walked with crutches till the fracture union. His complex fracture united in 3
months (see final X-ray) .
But what is important is that he regained
his full function in 3 months. You can see him sitting cross legged 3 months
down the line and his video shows clearly how his knee bends!
Stanford surgeons put artificial bone in 3-year-old's arm
Surgeons at Stanford University's Lucille
Packard Children's Hospital have implanted a telescoping artificial prosthesis
in the arm of a 3-year-old to replace a humerus that was removed because of
cancer. Nearly a year later, now-4-year-old Mark Blinder is thriving and
cancer-free.
Mark began developing pain in his arm, oncologists had diagnosed Ewing's sarcoma, a rare bone tumor. Chemotherapy reduced the pain, but did not
completely destroy the tumor. Radiation could have been used, but that would
have destroyed the growth plates in the bone, producing a physical impairment
as he grew.
The other common alternative was amputation.
Orthopedic surgeon Dr. Lawrence Rinsky of
Stanford convinced parents Alla Ostrovskaya and Gene Blinder to consider a
third option, an artificial bone. The titanium/cobalt chrome expandable bone designed specifically for
Mark was much rarer, spokesman Bill Kolter said.
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The prosthetic bone had to be small enough
to fit in a 3-year-old's arm, durable enough to last a lifetime and expandable
to allow for Mark's growth. Most artificial bones, furthermore, are used to
replace only part of a bone, so they are glued securely to remaining bones. In
Mark's case, the entire humerus was removed, so the prosthetic had to be
attached to soft tissue.
Once the old bone was removed, Rinsky
implanted the artificial bone, sewing a piece of Dacron fabric attached to the
top to soft tissue in Mark's shoulder. At the elbow, Rinsky saved the ligaments
and placed them around the prosthetic as best he could.
Subsequent studies showed that the tumor
was entirely removed. Mark spent a month recuperating from the surgery, then
received more chemotherapy as a safety measure. He will have three to four
minor surgeries over the next few years in which Rinsky will make a minor
incision in the shoulder and use a few turns of a screwdriver to
lengthen the implant.
Mark is gradually relearning how to use his
arm. He's moving the right wrist and fingers, can pick up small objects, and is
receiving physiotherapy to rebuild strength and flexibility in the elbow and
shoulder. He won't ever regain full function in those joints, but he is using
the arm more each day, his mother said. Mark often tells his family, "I
have a special arm."
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