In a Trailblazing approach, Aakash Healthcare Surgeons rebuilt Children’s Lower Limbs using Mothers’ Bone
New Delhi: A 16-year-old girl whose thigh bone was destroyed by chronic infection in 2021 is now five years past surgery, and the bone rebuilt with her mother’s own fibula is still growing well. Her case led surgeons at Aakash Healthcare Super Speciality Hospital to use maternal fibula grafts in children’s legs, claiming not tried before.
Surgeons adopted maternal fibula grafting, previously reported only for the upper limb, to treat children with bone cancer and chronic infection in lower limbs
The surgical team was led by Dr. Aashish Chaudhry, Director & Head, Orthopaedics & Robotic Joint Replacement, Dr. Arun Kumar Giri, Director of Surgical Oncology, and Dr. Abhishek Kumar Sambharia, Consultant Orthopaedics, Aakash Healthcare.
When the first child came to the hospital, the team searched the medical literature and found that maternal fibula grafts had been used only for upper-limb problems in children. They decided to implement the same technique in the lower limb. In 2021, the 16-year-old girl, who had chronic osteomyelitis of the right femur with an antibiotic spacer in place, received a reconstruction using her mother’s fibula. In 2022, a 14-year-old girl with chronic femur infection and a malunited pathological fracture was treated the same way.
Four more children, from Uzbekistan and Tajikistan, have since been treated, three of them for cancer. A five-year-old from Uzbekistan had a malignant tumour in his right femur removed on 10 September, and a long segment of the bone was rebuilt with a strut from his mother’s fibula, secured with a plate. Five days later, an eleven-year-old boy, also from Uzbekistan, and who had chondroblastic osteosarcoma of the right distal femur, had his tumour excised and the bone above the knee reconstructed with his mother’s fibula and a custom-made plate. Both children had been advised above-knee amputation in their home countries and both families travelled from Uzbekistan to Delhi for the surgeries,
In September itself, a three-year-old boy from Tajikistan, who had completed five cycles of chemotherapy for Ewing’s sarcoma, had the tumour removed from his right humerus and the bone rebuilt with a strut from his mother’s fibula. An Uzbek girl of about 11, living with an infected, non-healing congenital pseudoarthrosis of the left tibia, had infected bone and old implants cleared in April. Her mother’s fibula was grafted in May, along with ankle fusion and a customised plate.
“When that first mother offered her bone, we had very little to guide us,” said Dr. Aashish Chaudhry. “We read everything we could and found it had only been done for the arm. We asked ourselves whether it could work in the leg and decided the child deserved the chance, otherwise, these children would have been doomed to amputation.”. Five years later, her bone is growing, and she is walking and living her life. That is the best proof we could ask for.”
“A mother’s bone does more than fill a gap,” he added. “It is a gift of her own body, and it carries the same biology. What stays with me is the mother asking, before surgery, ‘Is my bone strong enough for my child?’ Mothers have given these children life once. Here, they helped them walk again.”
Dr. Chaudhry noted that the approach also helps families practically, since a matched, readily available graft can be used where the child’s own bone has been lost to disease. The surgeries were performed with mother and child under close monitoring, and the team stressed that the mother’s recovery matters as much as that of children’s.
