Fibula flap used to reconstruct ilium after sarcoma resection

A patient with a history of multiple hereditary exostoses developed a right ilium chondrosarcoma and underwent massive resection of the iliac wing and tumor to the sacroiliac joint with preservation of the acetabulum. The defect was reconstructed with an ipsilateral vascularized free fibula graft (A) as a double barrel construct osteotomized about mid-length and fixated as two separate struts using transfixion screws. The microvascular anastomosis was performed between the peroneal artery and vein pedicle of the fibula to the superior gluteal pedicle. The postoperative radiograph demonstrates the fibula reconstruction (B).