Surgical treatment of bone sarcomas of the fibula. Analysis of 19 cases

Nine patients with Ewing's sarcomas and seven patients with osteosarcoma of the fibula were treated surgically. The bone defect after tumour resection ranged from 5 to 25 cm (median 14 cm). Ten sarcomas were located in the proximal and six in the diaphyseal or distal fibula. Nine of ten patients with sarcomas located in the proximal fibula underwent a resection of the tumour including the common peroneal nerve. In one patient with a tumour in the proximal fibula, the peroneal nerve was preserved; however, this patient underwent amputation because of surgery with an intralesional margin. In five patients with a tumour in the distal fibula, the peroneal nerve was preserved. However, two of these five patients under went amputation as an adequate surgical margin could not be achieved during resection. All ten patients in whom the peroneal nerve was resected achieved satisfactory function by wearing a peroneal brace. In patients with Ewing's sarcoma of the proximal fibula, preservation of the common peroneal nerve may be chosen as an alternative possibility of resection.