fig3

Figure 3. Proximal tibia osteosarcoma resection and reconstruction with endoprosthesis. A: resection site after en bloc tumor resection; B: tumor specimen with hinged endoprosthesis for bone reconstruction; C and D: placement of endoprosthesis; E: total implant coverage with gastrocnemius and soleus muscle flaps; F: proximal and distal primary closure; G and H: central portion with exposed muscle flap and skin graft