Fig. 4

Patient No. 13. A 10-year old girl with osteosarcoma of the right proximal tibia. Preoperative plain radiograph (epiphysis width: 28.3 mm) (a). A radiograph after transepiphyseal excision without osteotomy of the distal tibia for the pedicle freezing. A 1.6-mm Kirschner wire was inserted as a guide, positioned under fluoroscopy. Osteotomy of the distal fibula was performed to expose the proximal part of the tibia (b). A radiograph after the reconstruction using a tumor-bearing frozen autograft stabilized with locking plate (aLDFA: 87°) (c). Whole-leg radiograph after 37 months (aLDFA: 86°, epiphysis width: 33.9 mm) (d)