Fig. 2

A Ewing sarcoma of the distal right fibula with purely intraosseous second localization in the homolateral proximal tibia in a 9-year-old boy. B Subperiosteal resection of the tibial localization with the previous site of biopsy. Tripod reconstruction was performed with non-vascularized autografts (2 fibulas and one tibia cortical). The distal fibula tumor was removed (at the same surgical time) (footnote: star: periosteum preserved). C Gross specimen with posterior and medial aspects. Proximal tibia without its periosteum and only the previous site of biopsy was resected with the tumor (footnote: star: anterior tibial tuberosity). D Serial radiographs showing rapid bone consolidation and good reconstruction. E Good functional result at 3-year follow-up. Little lower limb discrepancy. MSST = 28/30