Transposition of a vascularised distal femoral bone graft after wide resection of a diaphyseal Ewing's sarcoma--a salvage procedure.

We report a case of a 26-year-old woman with a surgical stage IIb lesion of Ewing's sarcoma of the left femur diaphysis. After intracompartmental wide resection a custom-made diaphyseal spacer was inserted for optional secondary biological reconstruction. Treatment-associated complications such as loosening of the implant and a septic process made a limb-preserving procedure impossible, and therefore a salvage procedure with transposition of the vascularised distal femur as a graft for lengthening of the short proximal femur was necessary. This unfortunate course is an example of limb-salvage surgery that not infrequently leads to reoperations or ultimately an amputation. Therefore individual surgical procedures have to be considered to provide the best limb function.