PMC8650678_01
(a) Preoperative X-ray of the patient demonstrating the mass at the proximal femur. (b) Preoperative coronal section.
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F1
Prior to his visit, imaging with X-rays and magnetic resonance imaging (MRI) followed by a biopsy were performed at an external center with a diagnosis of osteosarcoma (Figure 1).
(a) Epiphysis of the femoral head spared. (b) A branch of the obturator artery in the ligamentum capitis femoris preserved. (c) Cryoablation of the resected proximal femur segment. (d) The VFG was integrated to the cryoablated bone with a PHILOS plate.
VFG: Vascularized fibular grafting.
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F2
Turkey) (Figure 2). The vascularized fibula was microsurgically anastomosed to the perforating femoral arteries and veins.
(a) Immediate postoperative X-ray image. (b) Postoperative single-photon emission computed tomography image showing a viable graft tissue. (c) X-ray at final follow-up three years after surgery.
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F3
He was discharged with a unilateral hip spica cast (Figure 3a).  Three years after surgery, the patient remained disease-free (Figure 3c), could walk without assistance, and was able to flex his left hip to 145  (Figure 4).
(a) Patient standing upright and bearing full weight three years postoperatively. (b) He is able to flex his hip to 145  and squat without assistance.
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F4
Three years after surgery, the patient remained disease-free (Figure 3c), could walk without assistance, and was able to flex his left hip to 145  (Figure 4).