PMC2257950_01
Pre-Operative MRI coronal view of Case Patient showing local cancer recurrence involving left pelvis and surrounding the saddle prosthesis.
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F1
She represented to our unit 5 years following saddle-prosthesis surgery with local tumor recurrence within the pelvis and surrounding the prosthesis. (Figure 1) No systemic recurrence was detected on chest CT, whole body Tc99-bone scan or Thallium scan.
Diagrammatic outline of skin incision (posterior lateral view).
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F2
Skin incision was made as shown. (Figure 2) In brief, skin incision commenced proximal to the anterior superior iliac spine aiming posterior and parallel to the iliac crest.
Post operative 3D reconstruction of pelvis and neo-thigh. Note the 180 degree rotation of tibia-fibula and fixation of calcaneus to ileosacral osteotomy site.
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F3
The calcaneus was the fixed to the sacrum with two sternal wire cerclages. (Figure 3) The quadriceps muscle flap was then sutured to the fillet flap on the calf, thereby forming a neo-thigh stump.