PMC9910223_01
Preoperative images a) anterior-posterior radiograph, b) lateral direct radiograph, c) MRI T1 coronal section, d) MRI T2 coronal section, e) MRI T2 axial section, and f) axial tomography section. MRI: Magnetic resonance imaging
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FIG1
Neoadjuvant chemotherapy (CT) was completed in the patient who had localized disease at the time of diagnosis, and radiological images of the patient after CT showed an intramedullary tumoral lesion located distal to the left tibia diaphysis (Figure 1).
Intraoperative images a) dissection and retraction of the vascularized fibula, b) tibial tumoral segment osteotomized, c) tibial segment packed for radiotherapy, d) ipsilateral fibula placed in the defect with its pedicle, e) irradiated tibia was placed in its anatomical location and stabilized with a plate, f) scope image of the ipsilateral pedicled fibula placed in the proximal tibial medulla, and g) scope image of the ipsilateral pedicled fibula placed in the distal tibial medulla
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FIG2
In addition, the irradiated tibia was stabilized to the plate with two screws (Figure 2).
Postoperative images a) anterior-posterior radiograph, b) lateral direct radiograph, c) CT angiography found that the fibular artery was working, d) 12-month anterior-posterior radiograph, and e) 12-month lateral direct radiograph
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FIG3
No recurrence or metastasis was detected in the 12-month follow-up, and the patient is satisfied with her life (Figure 3).