Reconstruction of the clavicle in the pseudarthrosis after radiation therapy

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Abstract

The paper presents a clinical case of reconstruction of the clavicle with an atrophic pseudarthrosis in a 39-year-old patient who had a highly differentiated liposarcoma at the stage of fracture treatment. The treatment was combined with a course of gamma therapy in a total focal dose of 60 Gy. Remission has been achieved. Reconstruction was performed against the background of fibro-atrophic changes, grade 2 skin, and subcutaneous tissue lesions, grade 2–3 bone tissue according to the LENT/SOMA scale. To eliminate the clavicle defect, support osteogenesis, and cover the clavicle in the area of fibro-atrophic changes in soft tissues, the reconstruction was performed using a vascularized musculoskeletal complex of tissues rotated on a feeding pedicle. Fusion has been achieved, and the limb function was restored. The discussion provides a rationale for using a vascularized complex of tissues based on ideas about pathological changes in tissues in the area of local radiation exposure.

About the authors

A. S. Zelyanin

The I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation

Author for correspondence.
Email: microsurgery@inbox.ru

доктор медицинских наук

Russian Federation, Moscow

A. A. Sokov

The Main Clinical Military Hospital of the FSB of Russia

Email: sasha-sokov@mail.ru
Russian Federation, Golitsyno, Moscow Region

M. Yu. Khanin

The Main Clinical Military Hospital of the FSB of Russia

Email: microsurgery@inbox.ru

кандидат медицинских наук

Russian Federation, Golitsyno, Moscow Region

I. V. Klyuchevskii

The Main Clinical Military Hospital of the FSB of Russia

Email: microsurgery@inbox.ru
Russian Federation, Golitsyno, Moscow Region

A. A. Sakharov

The Main Clinical Military Hospital of the FSB of Russia

Email: microsurgery@inbox.ru
Russian Federation, Golitsyno, Moscow Region

D. S. Kovalenko

The Main Clinical Military Hospital of the FSB of Russia

Email: microsurgery@inbox.ru
Russian Federation, Golitsyno, Moscow Region

A. A. Gusev

The Main Clinical Military Hospital of the FSB of Russia

Email: microsurgery@inbox.ru
Russian Federation, Golitsyno, Moscow Region

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Copyright (c) 2022 Zelyanin A.S., Sokov A.A., Khanin M.Y., Klyuchevskii I.V., Sakharov A.A., Kovalenko D.S., Gusev A.A.


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