{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T08:42:19Z","timestamp":1779093739281,"version":"3.51.4"},"reference-count":24,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T00:00:00Z","timestamp":1621900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>For patients too young to be fitted with an expandable prosthesis, limb salvage surgery requires other strategies. The main problems are related to the impossibility of implanting an expandable prosthesis to the residual bone growth that is much too big in relation to the bone size, with the precocious implant loosening and\/or the residual absence of bone growth, as well as the problem of limb length and shape difference. In this paper, we report a possible reconstruction solution using a composite prosthesis for an Ewing\u2019s sarcoma of the proximal femur in an infant patient. After resection, a femoral stem was cemented into the distal third of a homoplastic humerus; a carbon fiber plate was used to stabilize the bone\/homograft interface. At the one-year follow-up, the patient was free of disease and able to walk with only a slight limp. This case report describes a possible solution for very small patients. An adult humerus is of the right size to replace a child\u2019s lower limb segments, and the distal humerus can be shaped, maintaining a cortex stiff enough to support a prosthesis. Very young patients might obtain a faster osteointegration of the graft than adults, due to their higher biological activity and, in this case, the diapasonal shape of the allograft might also have contributed to accelerated fusion. Moreover, the use of a graft to fit the prosthesis avoids loosening issues due to canal widening, hypothetically providing more growing time before system failure and revision surgery. However, although this technique is promising, further studies are necessary to confirm our findings and to verify if this procedure allows easier future prosthesis implantation.<\/jats:p>","DOI":"10.3390\/children8060442","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T02:53:36Z","timestamp":1621911216000},"page":"442","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A New Proximal Femur Reconstruction Technique after Bone Tumor Resection in a Very Small Patient: An Exemplificative Case"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8847-6772","authenticated-orcid":false,"given":"Carmine","family":"Zoccali","sequence":"first","affiliation":[{"name":"Oncological Orthopaedics Department, IRCCS\u2014Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2468-7172","authenticated-orcid":false,"given":"Silvia","family":"Careri","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Piazza di Sant\u2019Onofrio 4, 00165 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dario","family":"Attala","sequence":"additional","affiliation":[{"name":"Muscular-Skeletal Tissue Bank\u2013IRCCS\u2013Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Florio","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Piazza di Sant\u2019Onofrio 4, 00165 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0250-6043","authenticated-orcid":false,"given":"Giuseppe Maria","family":"Milano","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology and Stem Cell Transplantation, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Piazza di Sant\u2019Onofrio 4, 00165 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9646-8892","authenticated-orcid":false,"given":"Marco","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Bambino Ges\u00f9 Children\u2019s Hospital, IRCCS, Piazza di Sant\u2019Onofrio 4, 00165 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2536","DOI":"10.1200\/JCO.2008.19.1478","article-title":"Dose-intensified compared with standard chemotherapy for nonmetastatic ewing sarcoma family of tumors: A children\u2019s oncology group study","volume":"27","author":"Granowetter","year":"2009","journal-title":"J. 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