Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2019; 10(4): 212-218
Published online Apr 18, 2019. doi: 10.5312/wjo.v10.i4.212
Recalcitrant distal humeral non-union following previous Leiomyosarcoma excision treated with retainment of a radiated non-angiogenic segment augmented with 20 cm free fibula composite graft: A case report
Martin Gathen, Grayson Norris, Simon Kay, Peter V Giannoudis
Martin Gathen, Department of Orthopedics and Trauma Surgery, University Hospital of Bonn, Bonn 53129, Germany
Grayson Norris, Peter V Giannoudis, Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Leeds LS3 3EX, United Kingdom
Simon Kay, Plastic and Reconstructive Surgery, School of Medicine, University of Leeds, Leeds LS3 3EX, United Kingdom
Author contributions: Gathen M reviewed the literature and drafted the manuscript. Giannoudis PV and Kay S were the patient’s surgeons, reviewed the literature and contributed to manuscript drafting; they were also responsible for the revision of the manuscript for important intellectual content; Norris G reviewed the literature and contributed to manuscript drafting; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: All Authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist and the manuscript was prepared and revised according the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Peter V Giannoudis, BSc, MBBS MD, FACS, FRCS(Eng), Professor, Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds, Great George Street, Leeds LS1 3EX, United Kingdom. pgiannoudi@aol.com
Telephone: +44-113-3922750 Fax: +44-113-3923290
Received: December 14, 2018
Peer-review started: December 14, 2018
First decision: January 11, 2019
Revised: February 27, 2019
Accepted: March 12, 2019
Article in press: March 12, 2019
Published online: April 18, 2019
Processing time: 125 Days and 5.2 Hours
Core Tip

Core tip: We present an innovative treatment alternative for segmental bone defects after pathological fracture, tumor resection and radiation of the humerus. A combination of Induced membrane, vascularized fibula graft and double plate fixation was used to bridge a segmental bone defect. Devascularized bone stock was left in situ as a scaffold and not resected as usual. The treatment approach led to a successful clinical outcome and can be considered in similar complex cases.