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Seu et al. Plast Aesthet Res 2017;4:209-14 Plastic and
DOI: 10.20517/2347-9264.2017.47
Aesthetic Research

www.parjournal.net
Topic: Complex Reconstruction of the Face, Breast and Wounds with Microvascular Free Flaps Open Access

Proximal femur reconstruction using a

vascularized fibular epiphysis within a

cadaveric femoral allograft in a child with

Ewing sarcoma: a case report

Michelle Y. Seu , Allison Haley , Brian H. Cho , Hannah M. Carl , Tobias J. Bos , Aladdin H. Hassanein , Alison L.
1
1
1
1
1
1
Wong , Carol D. Morris , Justin M. Sacks 1
3
2
1 Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
2 Department of Plastic and Reconstructive Surgery, Dalhousie University School of Medicine, Halifax, Nova Scotia B3H 4R2, Canada.
3 Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Correspondence to: Mr. Michelle Y. Seu, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine,
Baltimore, MD 21205, USA. E-mail: mseu1@jhmi.edu
How to cite this article: Seu MY, Haley A, Cho BH, Carl HM, Bos TJ, Hassanein AH, Wong AL, Morris CD, Sacks JM. Proximal femur reconstruction
using a vascularized fibular epiphysis within a cadaveric femoral allograft in a child with Ewing sarcoma: a case report. Plast Aesthet Res 2017;4:209-14.
ABSTRACT
Article history: Periarticular reconstruction of appendicular bones in skeletally immature patients after tumor
Received: 30 Jun 2017 resection is a surgical challenge that requires a multidisciplinary approach. The authors present
First Decision: 26 Oct 2017 a case of Ewing sarcoma of the proximal femur in an 8-year old girl treated with wide resection
Revised: 6 Nov 2017 of the primary tumor and reconstruction using a vascularized fibula epiphyseal autograft within
Accepted: 27 Nov 2017 a cadaveric femoral allograft. The native femoral head was preserved to restore articular
Published: 30 Nov 2017 anatomy. Postoperative course was without complications. This report demonstrates the use
of a vascularized fibula autograft within a cadaveric femoral allograft to optimize growth
Key words: potential and joint durability in a pediatric patient.
Femur reconstruction,
vascularized fibula autograft,
Ewing sarcoma

INTRODUCTION standard of care for localized ES combines surgical
resection of the primary tumor with neoadjuvant and
Reconstruction of bones of the appendicular skeleton adjuvant chemotherapy to eliminate micrometastases
[2]
in pediatric patients poses a difficult challenge for and minimize the risk for recurrence .
[1]
reconstructive surgeons . Treatment for Ewing
sarcoma (ES), a common bone malignancy in Complete surgical resection of the primary tumor
individuals under the age of thirty years, often requires and reconstruction using traditional prostheses often
[1]
a complex, multi-disciplinary approach . The current has good outcomes for adult patients [3,4] . However,
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