Bologna, September 16, 2026 – Panama asks Rizzoli for help. And Rizzoli responds present. An eight-year-old child with a humerus tumor was operated on in the Central American state by two surgeons from the Rizzoli Orthopedic Institute of Bologna, called by Panamanian colleagues to perform a particularly complex and delicate surgery. The protagonists of the mission, and of the planning of the surgery, were Costantino Errani, orthopedic oncologist of Clinic 3, and Paolo Sassu, orthopedic surgeon of Clinic 4 Orthoplastics, directed by Prof. Marco Innocenti.
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The difficulty of the surgery
“In such a small child the greatest complexity is represented not only by the removal of the tumor but also by the reconstruction once the part of the bone affected by the tumor has been removed – explains Dr. Errani, who received the support request from his colleague in Panama City Ahmed Atherley, former fellow (specialist medical trainee) at Rizzoli –. Since an important segment of bone and the growth cartilage, essential to ensure the lengthening of the bones during the child’s growth phase, are missing, a classic reconstruction would have been disabling: one limb would have remained shorter than the other.”
Errani and Sassu collaborated with the team of the public hospital Ciudad de la Salud in Panama City to perform the delicate surgery, lasting over 10 hours. And the operation was fully successful. “We evaluated reconstructing the proximal humerus – continues Errani – with a vascularized growing fibula, which allows not only to reconstruct the humerus but also for the fibula to grow and ‘transform’ into a humerus assuming its function and preventing the limb from remaining shorter than the other.”
The cutting-edge surgical technique
We are talking about a cutting-edge surgical technique: at Rizzoli it had already been implemented in only a few selected cases. “It was not only about removing the tumor but about performing an anatomical reconstruction using the operating microscope and delicate microsurgical techniques,” highlights Dr. Sassu. In this way, in fact, the blood vessels of the fibula are “connected” to the vessels of the arm. The transplanted bone thus immediately receives blood and oxygen which facilitate its integration and consolidation.
The mission was supported by the Ministry of Health of Panama, where Errani and Sassu were invited for a meeting with the minister, and the Fittme association, which deals with assistance to cancer patients in the Central American state. The Bologna prefecture instead guaranteed Rizzoli the necessary support for the timely organization of the mission.
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