title: Proximal tibial reconstruction with auto transplantation of the fibular growth plate: two case reports, describing the surgical technique.
abstract: BACKGROUND
  Tumors of the proximal tibia, in children, can affect the growth plate and pose a challenge to further reconstruction of the bone defects resulting from tumor resection. Reconstruction methods do not always compensate the potential for bone growth in this segment. We present a new surgical technique of bone reconstruction, based on the transposition of the ipsilateral fibula with its growth plate and the use of an internal sliding fixation device, without need for microsurgical technique.
  
  
  METHODS
  We report two patients with osteosarcoma of the proximal tibia affecting the growth cartilage who were treated with the new technique.
  
  
  RESULTS
  In both cases, bone healing, hypertrophy and longitudinal growth of the transposed fibula were documented.
  
  
  CONCLUSIONS
  This new technique preserves the blood supply of the auto-transplanted bone segment, maintaining physeal growth potential, with no need for microsurgery. The implant allows longitudinal bone growth, which was radiographically confirmed.
  
  
  METHODS
  Case report, Level IV.
authors.affiliation: Orthopedic Division, Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil ; R. General Jardim, 846 conjunto 41, CEP 01223010 São Paulo, SP Brazil.
authors.forename: Pedro Péricles Ribeiro
authors.initials: PP
authors.lastname: Baptista
authors.affiliation: Hand Surgery Division, Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil ; R. General Jardim, 846 conjunto 41, CEP 01223010 São Paulo, SP Brazil.
authors.forename: Cassiano Leão
authors.initials: CL
authors.lastname: Bannwart
authors.affiliation: Orthopedic Division, Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil ; R. General Jardim, 846 conjunto 41, CEP 01223010 São Paulo, SP Brazil.
authors.forename: Felipe Augusto Ribeiro
authors.initials: FA
authors.lastname: Batista
authors.affiliation: Oncology Orthopedic Division, Federal University of São Paulo - UNIFESP, São Paulo, Brazil ; R. General Jardim, 846 conjunto 41, CEP 01223010 São Paulo, SP Brazil.
authors.forename: Davi Gabriel
authors.initials: DG
authors.lastname: Bellan
keywords: Device; Fibula; Fixation; Growth; Physis; Sarcoma; Sliding; Tibialization; Transplant