Abstract: Primary malignant bone tumours of the distal tibia are very rare. Amputation was the standard surgical treatment with satisfactory functional results obtained using an appropriate prosthesis
[1]. But in the era of limb salvage, tumours of distal tibia are being dealt with limb salvage surgery to provide patients with a better quality of life
[2].
We report a case of limb salvage for non-metastatic osteosarcoma of the distal tibia using resection and reconstruction with custom mega prostheses and ankle arthrodesis [3]
Osteosarcomas of the distal tibia are rare. These tumours are usually treated with amputation [2]. We report a case of osteosarcoma of distal tibia in a 13year old female. The patient presented with complaints of pain and limping gait of 6 months’ duration. Imaging revealed a mixed lesion predominantly sclerotic with moth-eaten appearance, aggressive periosteal reaction in distal tibia. MRI revealed soft tissue involvement.
The patient received four cycles of neoadjuvant chemotherapy [4] she had a good clinical response by clinical and imaging evaluation. A distal tibial resection with custom mega prostheses reconstruction was done. The post-operative histopathology revealed an osteoblastic variant of osteosarcoma with 60% of necrosis. The patient completed two more cycles of same chemotherapy [4] the patient was on follow up since four months.
The post-treatment functional evaluation was done with “Revised Musculoskeletal Tumour Society Rating Scale [5]. And patient had a score of 26 of 30. The patient was able to walk without crutches
