A 11-year-old Bangladeshi boy recently underwent total femur replacement at a private hospital in the city.
Rajonya Chinmoy Paul, a resident of Tangai near Dhaka, was bedridden for months with bone cancer. He had been undergoing chemotherapy in Bangladesh earlier and was referred to Apollo Children’s Hospital.
Doctors here diagnosed his condition as osteosarcoma of the left distal femur (lower part of the thigh bone).
Osteosarcoma is high grade tumour that affects the ends of long bones. It is often found around the knee joint and occasionally around hips and arms. It requires aggressive treatment regimen as it could spread rapidly to other organs if not treated early. Conventionally the bone is amputated to save life.
R. Sankar, senior consultant, paediatric, orthopaedic and spine surgeon, replaced the femur with a prosthetic bone. He ensured that as much of the tissue as possible was saved to ensure stability to the bone.
“In normal circumstances distal femur (thigh bone) osteosarcoma is treated with removal of the tumour and replacement of the removed portion with a prosthesis. When we did a PET CT scan we found another tumour focus in the top part of the same femoral bone. There was no other lesion anywhere else in the body. Hence, we decided to go for limb salvage,” he said.
The challenge was to get the right prosthesisas the prosthesis should accommodate the child’s growth. It was also necessary that the soft tissue should be reconstructed to ensure that the prosthesis did not dislocate from the hip joint.
“We were able to isolate and preserve the nerves and blood vessels supplying the leg. We also constructed a special pouch around the hip joint to prevent hip dislocation in the future,” Dr. Sankar added.
The patient was discharged within a few days of surgery. A biopsy of the specimen revealed that the entire tumour had been removed. His wound healed well and he responded well to chemotherapy post-surgery.
The boy soon gained strength and began walking without support. He is expected to have a quality life after completion of chemotherapy, according to a hospital release.
