Imaginative surgery puts Ohio teen back on the field

COLUMBUS, Ohio (AP) — During his last season playing baseball at Fostoria High School this spring, pitcher Dugan Smith started seven games.

He lost six, but the one winner was a one-hitter. He also led the northwestern Ohio school’s Redmen in strikeouts, with 39.

To Dugan, it was a disappointing season. To most others, though, it’s a miracle he even plays the game.

When he was 10 years old, all Dugan wanted to do was play baseball. He dreamed of one day playing in the big leagues.

Instead, doctors discovered he had osteosarcoma, a rare bone cancer in his right leg. Soon after, surgeons at the Arthur G. James Cancer Hospital at Ohio State University amputated much of the leg to remove a softball-sized tumor.

But the surgeons had an idea to give Dugan more mobility — a rotationplasty, a procedure performed a dozen or so times a year in the United States. Here’s how it works: What used to be the shin and calf are turned around and reattached to function as the thigh, and what used to be the ankle and foot — backward now as well — work as the knee.

Most parents of children with osteosarcoma opt for a more normal-looking reconstruction, but this decision ultimately was left up to Dugan. He said yes.

“It really let him go back and be a kid again,” said Dr. Joel Mayerson, an orthopaedic oncologist at the James. “And that’s the goal. After going through the nightmare of cancer as a child, you want them to feel normal.”

All teenagers have trouble growing into their bodies, but not many have to grow into their prosthetic.

At the time of his surgery in 2008, Dugan was a little less than 5 feet 10 inches tall. Mayerson had to estimate how tall Dugan would grow and reconstruct his right leg so it was longer than his left. After his surgery, both of Dugan’s legs grew, but the reconstructed leg grew less.

When Dugan first tried to play baseball after his surgery, he limped. Umpires asked his coaches what was wrong. “He really hated that,” said Dustin Smith, Dugan’s father, who coached his baseball team and helped coach basketball.

Dugan, now 18, is 6 feet 5 inches tall. Now, when umpires learn that Dugan wears a prosthetic leg, they’re dumbfounded.

“We got pretty close to right,” Mayerson said.

Making sure Dugan had a durable prosthetic that would hold up to his athletic lifestyle proved to be another issue.

During his senior year, Dugan’s basketball team was in the middle of a grueling, back-and-forth battle with Genoa High School. In the third quarter, Dugan felt something crack.

“He said, ‘Dad, my prosthetic broke,'” Mr. Smith said. “I couldn’t see anything broken and he could still walk, so I was a little frustrated, but we took him out of the game.”

Dugan sat on the bench, gritting his teeth as the game came down to the last second. When Fostoria won with a 3-pointer at the buzzer, he jumped in the air, cheering. When he landed, his prosthetic snapped.

Dugan uses his right leg to push off when he pitches, often at speeds faster than 80 mph.

“I never would have been able to guess in a million years that he’d be able to throw that hard,” Mr. Smith said.

In the fall, Dugan will attend Bowling Green State University, where he hopes to walk onto the baseball team. His ultimate goal, though, is medical school.

Throughout high school, Dugan has spoken to Mayerson’s patients considering rotationplasty. One of them was a 6-year-old boy going through his own battle with cancer.

“Now, he’s snowboarding and playing sports,” Dugan said. “I just really had a connection with him. I feel like that is why I was put here and why this happened to me. I want to be able to help everyone I can.”


Information from: The Columbus Dispatch,