Long-term outcome after a limb salvage procedure using a femoral head allograft following the resection of a synovial sarcoma affecting the hindfoot.
Case Report
The hindfoot is an uncommon site for malignant tumours. While limb salvage procedures are now more common for treating bone sarcoma, there is limited information available on hindfoot reconstruction alternatives because of its low incidence and its challenging outcomes. We present a case report of a man in his late 60s with synovial sarcoma affecting the right heel (calcaneus and soft tissue). A wide resection was performed, followed by reconstruction using a femoral head allograft while preserving the subtalar joint and Achilles tendon insertion. Despite the partial reabsorption of the allograft at 8.4 years after surgery, excellent oncological and functional results were achieved.There are very few reports of calcaneal reconstruction following total or partial calcanectomy. Reconstructive options include the use of bone allografts, vascularized autografts, free vascularized musculocutaneous flaps and custom-made prosthesis replacement. The reconstruction technique described here, which uses an osteoarthritic femoral head allograft, is a relatively easy and widely available alternative. It has the potential functional benefits of preserving the subtalar joint and Achilles insertion if performed after a partial calcanectomy with geometric osteotomies.
