(FOSTORIA, Ohio) -- Watching Dugan Smith pitch, it is easy to imagine he is like any other 13-year-old on the baseball field. He's one of the best players on his team, and it's only a limp that causes him to favor his right side that hints that something might be wrong with his leg.
Look closer, and it becomes apparent that Dugan's right leg is on backward, with his ankle is where his knee would ordinarily be -- the result of a rare surgery that allowed him to survive cancer, and play ball with his teammates.
Dugan, from Fostoria, Ohio, was 10 years old when he limped for a different reason. He chalked it up to some knee pain from baseball practice, but after a battery of tests and doctor visits, Dugan received a sobering diagnosis: He had osteosarcoma, a cancerous bone tumor that usually develops during adolescence.
After 10 weeks of chemotherapy while wearing a full cast on his right leg, doctors gave several options for surgeries and treatments. But Dugan, now 13, could think of only one thing: baseball.
So Dugan decided on a rare surgery called Van Nes rotationplasty in which the infected part of the leg is removed, and the remaining limb below the cancerous portion is rotated 180 degrees and reattached, with the ankle acting as the knee. His other options included full amputation or a surgery that would replace his femur, or thighbone, with a cadaver or metal bone.
Doctors told the family that an amputation above the knee would require Dugan to use about 75 percent more energy to walk or run than with a normal leg. With the rotationplasty, it would take only about 30 percent more energy.
Dr. Joel Mayerson, an associate professor of orthopedic surgery and director of the musculoskeletal oncology at the James Cancer Hospital at Ohio State University College of Medicine, performed the surgery on Dugan.
The procedure took 21 hours. Doctors fused the bones together and sewed together muscles and blood vessels. Dugan's toes could then slide into the prosthetic, which acts as the lower half of his right leg.
Only about a dozen rotationplasties are performed in the United States each year.
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