Multiple Femoral and Tibial Lengthening with External Fixator and Intramedullary Magnetic Nail in the Setting of Distal Femur Resection Prosthesis

Bone tumors around the knee joint are successfully treated with prosthetic replacement. Therefore, intraarticular tumor resection with the growth plate leads to limb length discrepancy. In skeletally immature patients, a lifetime surgical plan involving lengthening sessions at selected age is essential for the reconstruction. In this case, we present the limb reconstruction after resectioning the distal femoral malignant bone tumor. Initially, preserving the knee joint with an intercalary resection was impossible, and the knee joint was replaced with a custom-made tumor replacement prosthesis. Until skeletal maturity, two tibial and femoral lengthening sessions were performed for the reconstruction in the setting of megaprosthesis. In the end, custom-made endoprosthesis was replaced with standard adult-type megaprosthesis.