Reconstruction of distal fibula with osteoarticular allograft after tumor resection

Background: Involvement of distal fibula by benign aggressive and malignant tumors usually necessitates resection of the involved segment of fibula. Numerous techniques have been proposed to reconstruct the ankle joint after this procedure, which can result in complications. We introduce reconstruction of ankle joint by fibular osteoarticular allograft. Methods: Reconstruction of the distal fibula after wide resection of tumor was carried out in four patients. There were two cases of Ewing sarcoma, one case of osteosarcoma and one giant cell tumor. After wide resection of tumor, we reconstructed the lateral side of the ankle joint by osteoarticular fibular allograft, which was applied and internally fixed with semitubular plate and screws. In the follow up period, we did assessment of complications, pain and ankle joint instability. Results: The mean age of our patients was 24.2 years (12-31). The mean follow-up was 3.2 years (1.5-6.7). In follow up visits there were no signs of infection or wound healing problems. Union was achieved in all patients. Conclusion: In cases of benign aggressive and malignant tumors involving the distal fibula, we can recommend resection of the distal fibula and reconstruction of the ankle with osteoarticular allograft of the distal fibula. (C) 2012 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.