Abstract
Background: A custom endoprosthesis allowed for the preservation of the distal femoral physis with a short remaining metaphyseal segment after osteosarcoma resection in a 10-year-old boy. CASE Case Presentation: This case illustrates a reconstructive alternative allowing physeal sparing with minimal remaining metaphyseal bone. At the three-year follow-up, the patient has remained complication-free with distal femoral growth maintaining symmetric limb length. Conclusion: When intercalary biologic reconstruction is not an option and the sacrifice of physis necessitates an extendible total femoral prosthesis, custom physeal sparing short segment press-fit fixation is an appropriate solution.
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