# Composite free fibula flap and bone allograft for calcaneus reconstruction: A rare case

## TL;DR

A 69-year-old woman with a rare ankle tumor underwent successful foot reconstruction using a combination of donated bone and a fibula flap, allowing her to return to normal activities.

## Contribution

A successful case of calcaneus reconstruction using a composite allograft and free fibula flap for a rare sarcoma.

## Key findings

- The patient's calcaneus healed well after 36 months with no daily life limitations.
- The combination of allograft and free fibula flap provided stable and functional reconstruction.
- This approach is presented as a limb-sparing option for calcaneus sarcomas.

## Abstract

Calcaneus sarcomas are extremely rare, but often nefarious. Its weight-bearing function makes reconstruction after calcanectomy exceptionally difficult, demanding a solid, stable and well-padded substrate. We report a 69 years-old female with a rare small-round-cell sarcoma in her left ankle, submitted to total calcanectomy and reconstruction with a composite calcaneus allograft and free fibula flap. After 36 months, the bone healed evenly with no limitations in her daily life. This advantageous combination of vascularized bone with allograft, allowed biological integration with the strengthful external construct, representing one of the best limb-sparing options for the calcaneus.