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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

AbstractFor 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.