case_images: PMC9826550_01
case_images: Pre-operative radiograph left femur.
case_images: JOCR-12-75-g001.jpg
case_images: PMC9826550_01_JOCR-12-75-g001.jpg
case_images: F1
case_images: X-ray of the left femur showed an osteosclerotic tumor in the medial aspect of the middle third of the left femur (Fig. 1).
case_images: Tumor cells producing osteoid and with chondroblastic areas. Pleomorphic spindle cells with eosinophilic cytoplasm and producing malignant osteoid (H and E, x40).
case_images: JOCR-12-75-g002.jpg
case_images: PMC9826550_01_JOCR-12-75-g002.jpg
case_images: F2
case_images: Areas of necrosis, deposition of thin, lace-like malignant osteoid, and chondroblastic differentiation were noted, features consistent with osteogenic sarcoma (Fig. 2).
case_images: Operative image and excised specimen of the femur.
case_images: JOCR-12-75-g003.jpg
case_images: PMC9826550_01_JOCR-12-75-g003.jpg
case_images: F3
case_images: A chevron osteotomy was made four fingerbreadths from the proximal and distal soft-tissue margin of the tumor, thus freeing the femoral diaphysis plus the encompassing tumor, from the rest of the left thigh tissues (Fig. 3).
case_images: Prepared femur autograft.
case_images: JOCR-12-75-g004.jpg
case_images: PMC9826550_01_JOCR-12-75-g004.jpg
case_images: F4
case_images: The femur autograft measured approximately 32 cm long (Fig. 4).
case_images: Immediate post-operative radiograph.
case_images: JOCR-12-75-g005.jpg
case_images: PMC9826550_01_JOCR-12-75-g005.jpg
case_images: F5
case_images: The femur autograft was replaced in the thigh, ensuring the chevron osteotomies fit well, and a locked intramedullary SIGN nail was placed (Fig. 5).
case_images: Radiograph of the left femur taken 1 year after surgery.
case_images: JOCR-12-75-g006.jpg
case_images: PMC9826550_01_JOCR-12-75-g006.jpg
case_images: F6
case_images: Radiographs done at 12 months post-operation demonstrated healing of the osteotomy sites with maintained implant position and the patient has normal lower limb function(Fig. 6, 7a, b).
case_images: (a) Knee range of motion-extension. (b) Knee range of motion- flexion.
case_images: JOCR-12-75-g007.jpg
case_images: PMC9826550_01_JOCR-12-75-g007.jpg
case_images: F7
case_images: Radiographs done at 12 months post-operation demonstrated healing of the osteotomy sites with maintained implant position and the patient has normal lower limb function(Fig. 6, 7a, b).