Erzsike Udvary has undergone a world-first operation at The Royal Children’s Hospital (RCH). Surgeons performed a procedure to allow her amputated right leg to continue growing by using her calf bone, flipping it upside down and attaching it to her thigh bone.
An amputation was the only way to save the nine-year-old’s life after she was diagnosed with osteosarcoma following the discovery of an aggressive tumour in the bone above her knee.
Her right leg had to be removed mid-thigh to remove the 8cm long tumour. The little amount of her femur left meant that it was too short for a prosthetic leg to fit onto.
Mum Rebecca said that Erzsike came to terms with the news quickly, and watching the Paralympics at the time helped her to see a bright future.
Erzsike faced using a wheelchair and crutches her whole life unless something could be done to lengthen her right thigh bone. This was not an option for committed parents Rebecca and Tim who conducted their own research. They read medical journals, studied overseas surgeries and asked surgeons to consider using the cut-off calf bone to lengthen her amputated leg.
It was RCH plastic surgeon Chris Coombs who offered a solution to the rare situation. Mr Coombs brought forward the idea of turning the tibia upside down and attaching it to the femur with a metal rod and a connection of arteries. He said that by flipping the removed tibia over the growth plate would face the ground, therefore continuing to grow the right way. This was based on the idea that the growth of the tibia occurs at the end of the bone.
Mr Coombs and orthopaedic surgeon Ian Torode performed the extensive eight-hour operation, which involved using a microscope to reconnect the arteries in the two legs. Lastly, to give the leg padding between the bone and prosthesis, the quadricep muscle was sewn over the end of the leg. This was to allow the thigh bone to grow in proportion.
Erzsike has returned to school with her prosthetic leg just two weeks after finishing chemotherapy. Her focus is now on hitting the beach next summer with her twin sister, under the watchful eyes of the RCH limb deficiency clinic.
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