Reconstruction of the first and second metatarsals with free microvascular fibular bone graft after resection of a Ewing sarcoma.

We report the case of a 12-year-old girl with a Ewing sarcoma originating from the first metatarsal of one foot. Because the girl and her parents refused amputation of the foot, we resorted to complete local resection and to reconstruction of the first and second metatarsals with a free microvascular fibular bone graft. At 3 1/2 years after surgery, the patient continues to walk without a limp, and the mechanical function of the forefoot has been largely restored, although considerable loss of function of the big toe is apparent. Details of the surgical technique and tumor management are described.