Functional Elbow Reconstruction After Complete Ulnar Resection for Ewing's Sarcoma: Radial Neck Transposition as a Biomechanical Alternative

尤文氏肉瘤尺骨完全切除术后肘关节功能重建:桡骨颈移位作为一种生物力学替代方案

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Abstract

INTRODUCTION: Ewing's sarcoma of the ulna is rare, and its wide resection poses challenges for preserving upper limb function. Elbow reconstruction must ensure joint stability and forearm mobility. Conventional alternatives, such as bone grafts and prostheses, have limitations, including a high risk of complications. OBJECTIVE: This study was aimed at reporting a case of elbow reconstruction using radial neck transposition to the humeral trochlea after ulnar resection for Ewing's sarcoma, evaluating the functional outcomes of this technique. METHODS: A 17-year-old male patient with Ewing's sarcoma in the ulnar diaphysis underwent complete ulnar resection. Radial neck transposition to the humeral trochlea was performed. Follow-up included functional assessment using the Musculoskeletal Tumor Society (MSTS) scale and postoperative imaging. RESULTS: After 2 years, the patient had an MSTS score of 28/30, with preserved wrist and hand mobility, full pronation, and supination reduced to half. Radiographic follow-up demonstrated proper alignment of the reconstruction, with no instability or bone resorption. CONCLUSION: Radial neck transposition proved to be a viable alternative for elbow reconstruction after ulnar resection, providing stability and functional preservation. Further studies are needed to validate its application on a larger scale.

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