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Vascularized Sural Nerve Graft and Extracorporeally Irradiated Osteochondral Autograft for Oncological Reconstruction of Wrist Sarcoma: Case Report and Review of Literature

Muramatsu, Keiichi MD; Moriya, Atsushi MD; Miyoshi, Tomoyuki MD; Tominaga, Yasuhiro MD; Seto, Shinichiro MD; Taguchi, Toshihiko MD

doi: 10.1097/SAP.0b013e31827aec5d
Peripheral Nerve Surgery and Research

For tumors that are located beside the main peripheral nerve, combined wide resection of both the tumor and peripheral nerve is mandatory. We here present an interesting case with synovial sarcoma of the wrist. An 8 cm of ulnar nerve defect was reconstructed by vascularized, folded sural nerve graft with the peroneal flap, whereas an 8 cm of distal ulna was reconstructed using extracorporeally irradiated osteochondral autograft. Our case showed excellent nerve regeneration. Extracorporeal irradiated osteochondral graft was a good option for reconstruction of the distal ulna. This procedure should be indicated for the reconstruction of non–weight-bearing joints. These kinds of reconstruction have been addressed in only a few cases of oncological reconstruction.

From the Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.

Received August 27, 2012, and accepted for publication, after revision, October 24, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Keiichi Muramatsu, MD, Department of Orthopedic Surgery, Yamaguchi University School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan. E-mail:

© 2013 by Lippincott Williams & Wilkins