It’s called a Van Nes Rotationplasty, and it preserved a rare cancer patient’s ability to play baseball.
After 12-year-old Dugan Smith was diagnosed with osteosarcoma – and a tumor on his thighbone – he had the option of having the diseased bone replaced with a cadaver bone or a manmade rod. Or it could be amputated altogether.
But instead, the doctors from Ohio State University Medical Center did the following:
- Cut off the middle part of the leg (including the knee and most of the thigh).
- Remove the tumor from the femur (thighbone).
- With the nerves still connected, turn the bottom part of the leg around 180 degrees.
- Reconnect the blood vessels.
- Then sew the lower half of the leg onto his hip – again, backwards – making the calf act as the thigh and the ankle act as his knee (pictured). The foot faces, well, backwards.
Within two hours, he could move his foot and toes – which slid into a partial prosthetic leg and foot to compensate for the missing lower half of the right leg.
The bone that’s there is “still alive, it still grows,” says OSU’s Joel Mayerson, who performed the surgery. And live bones are sturdier than the metal rods or cadaver bone.
According to the team, an amputation above the knee would require about 75% more energy to walk or run than with a normal leg. With the leg reversal surgery, it would take only about 30% more energy, and it also decreases the chances of a tumor recurrence.
According to the American Cancer Society, about 400 kids are diagnosed with osteosarcoma every year. It has a 5-year survival rate of 50 or 60%, according to Mayerson.
Risks from the surgery include a danger of clots developing when reconnecting the blood supply, infection, and damage to the nerves when twisting and stretching the leg. Only about a dozen rotationplasties are performed in the US a year.
Images: Ohio State University
