Case Report


Reconstruction of calcaneum using the deep circumflex iliac artery bone graft following wide local excision due to Ewing’s sarcoma: A case report on a rare disease presentation and its unconventional management

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1 Postgraduate Trainee, General Surgery, Shifa International Hospital, Islamabad, Capital Territory, Pakistan

2 Consultant/Professor, Plastic Surgery, Shifa International Hospital, Islamabad, Capital Territory, Pakistan

3 Senior Fellow, Plastic Surgery, Shifa International Hospital, Islamabad, Capital Territory, Pakistan

4 Professor and Head of the Department, Orthopaedics, Shifa International Hospital, Islamabad, Capital Territory, Pakistan

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Zoha Sajid Qureshi

Postgraduate resident-year 1, General Surgery, Shifa International Hospital, Islamabad,

Pakistan

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Article ID: 101416Z01ZQ2023

doi: 10.5348/101416Z01ZQ2023CR

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How to cite this article

Qureshi ZS, Rashid M, Malik S, Hafeez S. Reconstruction of calcaneum using the deep circumflex iliac artery bone graft following wide local excision due to Ewing’s sarcoma: A case report on a rare disease presentation and its unconventional management. Int J Case Rep Images 2023;14(2):85–90.

ABSTRACT


Introduction: Ewing’s sarcoma of the calcaneum, although rare, is a significant health threat as it is quick to spread locally and systemically reducing the overall survival rates. Conventionally, below knee amputation was used as its only management. Currently, due to numerous advancements, wide local excision following reconstruction is the treatment of choice worldwide.

Case Report: This case report provides clinical and functional outcomes of using deep circumflex iliac artery bone graft for calcaneal reconstruction. The follow-up duration in our study was two years. Normal ambulatory status, post-procedure, was achieved within nine months with a good range of motion at ankle joint both actively and passively. No donor site morbidity was seen and radiological imaging confirmed a healthy and viable graft with negative oncological margins.

Conclusion: Our choice of graft proved to be a suitable option for calcaneal reconstructions as the curvature of iliac crest resembles calcaneal tuberosity. The ability of its osseous flap to naturally fit the area of defect makes it the most appropriate choice for the reconstruction of the heel of the foot.

Keywords: Calcaneal tumors, Deep circumflex iliac artery bone graft, Ewing’s sarcoma, Limb salvage

SUPPORTING INFORMATION


Author Contributions

Zoha Sajid Qureshi - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Mamoon Rashid - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Sakina Malik - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Sohail Hafeez - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published

Guarantor of Submission

The corresponding author is the guarantor of submission.

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None

Consent Statement

Written informed consent was obtained from the patient for publication of this article.

Data Availability

All relevant data are within the paper and its Supporting Information files.

Conflict of Interest

Authors declare no conflict of interest.

Copyright

© 2023 Zoha Sajid Qureshi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.