CLEAR-CELL CHONDROSARCOMA OF THE DISTAL ULNA TREATED WITH WIDE RESECTION AND FASCIA LATA SUSPENSOPLASTY: A CASE REPORT
In front a case of either aggressive or malignant tumor of the distal ulna, wide resection with free margin is the procedure of choice, however when performed alone, this procedure can produce loss of motion, impingement and pain, being necessaire to perform stabilization procedures.
We presented a case-report of a patient treated with wide ulna excision and stabilization by a fascia lata tendon strip
A 35-year-old male patient suffered a pathologic fracture of the distal ulna being diagnosed, after open biopsy, clear-cell chondrosarcoma. To ensure free margin excision, we resected 11 cm of the distal ulna, as well as the distal radioulnar joint, extensor carpi ulnaris and the TFCC. After, we harvested a 2.5x15cm fascia lata tendon strip and performed and suspensoplasty of the proximal stump with the fascia lata strip and the flexor carpi ulnaris.
At the 18-month follow-up, the patient presents extremely satisfied with the procedure, he presents and excellent result in the Ferracini Score (16/18), his PRWE was of 22/100, his QuickDash was of 15.9. In terms of motion he has normal flexion-extension and prono-supination motion compared to the contralateral side and a decrease of 10 degrees in the radioulnar deviation compared to the contralateral side. His grip strength is of 24kg (81% compared to the contralateral side). He has no pain on neither the wrist nor the tight and no signs of recidive at this point
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The management of tumors of the distal ulna is always individualized being the wide resection with or without stabilization the choice more usually performed. We showed that despite the big resection, the suspensoplasty with the fascia lata tendon is capable of providing and stable proximal stump and also maintaining a good grip strenght
Clear-cell Chondrosarcoma; Distal Ulna Excision; Fascia Lata Suspensoplasty
EXPERIMENTAL
Institut Européen de La Main - - Luxembourg
João Paulo Mussi, Rainer Andrea Falcone, Christophe Camps, Christophe Duysens, Germain Pommares, Alexandre Durand, Thomas Jager