The Leg Bone’s Connected to the Arm Bone: Surgeons Use Fibula to Reconstruct Humerus in Unique Pediatric Sarcoma Case

Orthopaedic oncologist discusses the complex case

Nathan Mesko, MD, an orthopaedic oncologist at Cleveland Clinic, says his job often requires creative solutions to restore function.

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This was certainly true in a recent case when a 5-year-old patient presented to Cleveland Clinic with substantial swelling in his right shoulder, his dominant arm. A thorough workup revealed that the patient had humeral osteosarcoma. The pediatric oncology team began chemotherapy immediately. Next, was Dr. Mesko’s challenge.

“The challenge of reconstruction was to provide this energetic, fun-loving 5-year-old with an arm that allowed his humerus and elbow to serve as a working platform for his hand while saving all of the important nerves and blood vessels in his arm, giving him a chance at some form of growth in that arm,” he explains.

Utilizing the free fibula transplant technique

Dr. Mesko shares more details about this case, including a collaboration with Graham Schwarz, MD, of Cleveland Clinic’s Department of Plastic Surgery. The teams worked together, utilizing a free fibula transplant technique to reconstruct the patient’s humerus. Learn more about this unique case in the video below:

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