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

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.