Functional reconstruction of the pelvic ring with simultaneous bilateral free fibular flaps following total sacral resection

The treatment of large sacral tumors involving the pelvis is challenging and may require radical resection. Sacral resection disrupts the continuity between the spine and pelvis, resulting in loss of skeletal support for weight bearing. Without pelvic reconstruction, patients remain nonambulatory. This report describes a case of functional pelvic ring reconstruction utilizing bilateral simultaneous free fibular flaps following radical sacrectomy. Vascularize free fibular grafts may be used to restore pelvic continuity for cases involving total sacral resection.