“Mark is a high-level athlete. He challenges me and beats me”
A cancerous tumor in his right femur left Mark DuMoulin with a considerable discrepancy in leg length. After surgery to remove the diseased bone, and subsequent operations to reconstruct, his right leg was still some two inches shorter than his left.
Mark tells how the story from the start: “One day, I got the phone call that I was diagnosed with cancer. First they give chemotherapy, then they removed the tumor which in my case meant removing approximately 21 centimeters of my femur bone.”
Mark’s surgeon was S. Robert Rozbruch, MD, Chief of the Limb Lengthening and Complex Reconstruction Service at New York City’s Hospital for Special Surgery. He describes the reconstructive procedure, called ‘trifocal bone transplant’: “The defect that he had in his femur was so dramatic. So, we cut the bone in two places and we transported from both ends to fill in this bone defect.”
Mark recalls, “He attached an external fixator on the leg. It looks like a metal structure with wires and pins that go through the skin down into the bone. So after all this is done, and we miraculously get this femur bone put back together, the right leg is [still] about two inches shorter than the left leg.”
Dr. Rozbruch says, “He had already been through a huge amount of surgery with the external fixator, using this bone transport over nail technique. And it was too much to try to get those two inches back through the femur, but to leave him two inches short just was not an option.”
Mark recounts his conversation with Dr. Rozbruch: “So, what’s the solution to that? ‘Well, we’re going to lengthen your tibia bone.’ So, I got to get another one of these frames put on? He says, ‘No, no they have this new nail out that lengthens internally. There’s no wires going through your skin.’”
Dr. Rozbruch describes the tibia lengthening nail: “Precice is a fully implantable, internal, lengthening, intramedullary nail. There’s nothing sticking out of the leg, there’s no external fixator. There’s a magnet in here, and there’s gears, and a telescoping rod.”
Mark picks up the story: “He drew with a Sharpie marker on my leg where the controller has to go. You slide it up and down a little bit, you can feel where the magnet kind of engages with the nail underneath.”
Pushing a button on the remote control device rotates the magnet, and that extends – the medical term is ‘distracts’ – the telescoping rod.
Mark says, “You did that four times a day in in my case, and then after six weeks or so, the length was right.”
Using the Precice nail, says Dr. Rozbruch, “We got him two inches of bone length in his tibia. With the internal lengthening apparatus, the rod is supporting that new bone. In the case of a two-inch lengthening, we typically have patients walking by three months; four months maximum.”
For Mark, the result is dramatic: “It’s sort of surreal to think about the fact that I have gotten back to this point in my life. I feel better now than I did in the years preceding my cancer diagnosis.”
Dr. Rozbruch says that Mark’s recovery is complete and comprehensive: “All his hardware has been removed; the femur nails, the tibia nail, and he has equal leg lengths, and he has beautiful straight leg, and it’s all natural normal bone. It’s not going to wear out. He’s been able to rehabilitate, and become extremely strong.”
Mark had a surprise request, says Dr. Rozbruch: “He said, ‘Hey I’d like to ride with you in the park because I know you’re an avid cyclist.’ Mark is a high level athlete, and he is able to not only keep up with me, but he challenges me and beats me.”
For Mark and his family, the result couldn’t be better: “We definitely wanted to enjoy this process. We wanted to feel like we could run around with the kids, and crawl around the floor with them. I love watching every little new thing that they do, and it’s just an amazing, amazing reward.”