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      Total talar replacement for metastatic pulmonary adenocarcinoma of the talus: A case report

      case-report

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          Key Clinical Message

          Talar metastases from malignant tumors are rare and poorly documented. Treatment requires gradual relief of pain and preservation of function, with a choice between palliative measures and surgery. This case indicates that total talar replacement is an effective intervention for localized talar metastases and highlights the importance of early intervention. A 48‐year‐old man was diagnosed with a pathologic talar fracture due to talar metastases was observed after 8 years of chemotherapy following a diagnosis of lung adenocarcinoma. Despite radiotherapy, the patient's activities of daily living (ADLs) deteriorated due to pain on walking, prompting a request for surgical intervention. Total talar replacement was performed, allowing the patient to begin full weight‐bearing ambulation 2 weeks post‐operatively. Total talar replacement appears to be an effective treatment for localized talar metastases and should be performed as early as possible.

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          Metastatic skeletal disease of the foot: case reports and literature review.

          Metastatic disease of the skeleton occurs in at least 20% to 30% of patients with malignancy, but metastasis to the foot and hand (acrometastasis) is extremely rare (0.007% to 0.3%). Metastases to the feet are even rarer and have been reported in half to one-third the rate for hand metastases. Failure to recognize these lesions has led to delayed diagnosis and/or inappropriate treatment. The purpose of this report is to highlight the clinical and radiologic features that aid in the diagnosis and potential treatment of this condition along with a pertinent review of the literature.
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            Treatment of Osteosarcoma of the Talus With a 3D-Printed Talar Prosthesis

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              Total talar replacement with a novel 3D printed modular prosthesis for tumors

              Purpose Arthrodesis is one of the most widely accepted surgical recommended methods for tumors of the talus, but it may be associated with poor limb functions. The aim of this study was to present a novel reconstruction with ankle function preserved after en bloc talus tumor resection. Patient and method A 43-year-old female with mesenchymal sarcoma of the talus was admitted in West China Hospital. Total talar replacement with three-dimensional (3D) printed modular prosthesis was prepared for reconstruction. The 3D printed modular prosthesis was designed exactly as the mirror image of the contralateral talus with complete filling of the sinus tarsi and subtalar joint space. The upper modular component of prosthesis was made of ultra high molecular weight polyethylene, and the lower component, titanium alloy. Pre-drilled holes in three directions were prepared for screw fixation of the subtalar joint. Results The patient underwent en bloc talus resection through anterior approach, followed by reconstruction with the 3D printed prosthesis. The whole procedure took 2 hours, and intra-operative blood loss was 50 mL. At the last follow-up, our patient was disease free and she could walk almost normally without any aid or pain. The Musculoskeletal Tumor Society score was 26/30. The American Orthopedic Foot and Ankle Society score was 91/100. The range of motion for dorsiflexion and plantar flexion was 40°. And no abnormalities were observed in the roentgenograph. Conclusion Total talar replacement with a 3D printed modular prosthesis may be an effective procedure for patients with tumors of the talus as it could maintain ankle function.
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                Author and article information

                Contributors
                f8524@cc.saga-u.ac.jp
                Journal
                Clin Case Rep
                Clin Case Rep
                10.1002/(ISSN)2050-0904
                CCR3
                Clinical Case Reports
                John Wiley and Sons Inc. (Hoboken )
                2050-0904
                21 June 2024
                June 2024
                : 12
                : 6 ( doiID: 10.1002/ccr3.v12.6 )
                : e9049
                Affiliations
                [ 1 ] Department of Orthopaedic Surgery, Faculty of Medicine Saga University Saga Japan
                Author notes
                [*] [* ] Correspondence

                Tatsuya Sakai, Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5‐1‐1 Nabeshima, Saga 849‐8501, Japan.

                Email: f8524@ 123456cc.saga-u.ac.jp

                Author information
                https://orcid.org/0000-0002-9700-8396
                Article
                CCR39049 CCR3-2024-02-0329.R1
                10.1002/ccr3.9049
                11192581
                38910834
                878f233f-0688-48fb-a7f4-aecbfa50bd33
                © 2024 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 27 April 2024
                : 06 February 2024
                : 25 May 2024
                Page count
                Figures: 4, Tables: 0, Pages: 5, Words: 2100
                Categories
                Orthopedics
                Case Report
                Case Report
                Custom metadata
                2.0
                June 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.4 mode:remove_FC converted:21.06.2024

                case report,metastatic bone tumor,pulmonary adenocarcinoma,talar replacement,talus

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