In what they are terming a medical first, surgeons at Stanford University’s Lucille Packard Children’s Hospital have implanted a telescoping artificial prosthesis in the arm of a 3-year-old to replace a humerus that was removed because of cancer.
Nearly a year later, now-4-year-old Mark Blinder is thriving and cancer-free.
Mark developed pain in his right arm in April last year, and by July oncologists had diagnosed Ewing’s sarcoma, a rare bone tumor.
Chemotherapy reduced the pain but did not completely destroy the tumor. Radiation could have been used, but that would have destroyed the growth plates in the bone, producing a physical impairment as the boy grew. The other common alternative is amputation.
Orthopedic surgeon Law rence Rinsky of Stanford persuaded parents Alla Ostrov skaya and Gene Blinder to consider a third option, an artificial bone produced by Biomet Inc. of Warsaw, Ind. Biomet produces artificial joints, which are quite common, and artificial bones, which are less so. The titanium/cobalt chrome expandable bone designed specifically for Mark was much rarer, spokesman Bill Kolter said.
The prosthetic bone had to be small enough to fit in a 3-year-old’s arm, durable enough to last a lifetime and expandable to allow for Mark’s growth. Most artificial bones are used to replace only part of a bone, so they are glued securely to remaining bones. In Mark’s case, the entire humerus was removed, so the prosthetic had to be attached to soft tissue.
Mark spent a month recuperating from surgery, then received more chemotherapy as a precaution. He will have three to four minor surgeries over the next few years in which Rinsky will make a minor incision in the shoulder and use a few turns of a screwdriver to lengthen the implant.
Mark is gradually relearning how to use his arm. He’s moving the wrist and fingers, can pick up small objects and is receiving physiotherapy to rebuild strength and flexibility in the elbow and shoulder. He won’t ever regain full function in those joints, but he is using the arm more each day, his mother said. Mark often tells his family, “I have a special arm.”
