According to previous
reports ,
ankle arthrodesis is regarded as the best reconstructive
procedure after
limb salvage surgery for
osteosarcoma of the distal
tibia . Of the many
arthrodesis options, vascularized fibular
graft (VFG) is widely accepted as the most successful
method . However, reconstruction using VFG is not always possible, because VFG is a complicated
surgical procedure and is associated with high rates of
morbidity at
donor sites. The authors devised a novel
reconstructive surgical procedure that exploits the osteogenic potential of the
periosteum . A 10-year-old
female patient with
osteosarcoma of the distal
tibia underwent
limb salvage surgery and the ipsilateral distal
fibula and periosteal sleeve were transported to the defect for
ankle arthrodesis . The transported
fibula and periosteal new
bone formation acted as a dual strut
bone graft providing better stronger stability than
fibula alone transfer. The authors believe the proposed
procedure is an easier alternative to the surgically demanding VFG
method .