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Objectives and questions: Surgical treatment of malignant bone tumors comprises tumor resection and reconstruction.

Prosthetic replacement is a commonly used reconstruction method which achieves good early function, but has a high long-term incidence of complications. Another reconstruction option is autologous bone replantation after devitalization of the living cells, which has the advantages of anatomical matching and no need for large bone bank support. Is Pasteurized autograft a good alternative method of biologic reconstruction for managing bone defects after tumor resection.

Material and methods: In this retrospective study between 2005 and 2020 we analyzed 10 patients of malignant bone tumors around the ankle with a follow-up of 2–15 years who underwent a surgical treatment in our institution.

Epidemiological data, radiographic and histological examinations, complications, local recurrence, radiographic and functional outcome were evaluated. The affected segment was excised with appropriate safety margins, pasteurized and replanted and fixed with locked plates.

Results: The study includes 8 males (80%) and 2 females (20%), with a mean age of 29 (18–40) years.

The most common pathology was conventional osteosarcoma (70%) with one patient had fibular osteosarcoma and six patients had tibial osteosarcoma with one of them had osteosarcoma on top of fibrous dysplasia. Two patients had tibial chondrosarcoma (20%) and one patient had tibial Ewing’s sarcoma (10%). Seven cases had intercalary segment affection and three cases had osteoarticular reconstruction. All cases had sound union with no infection. One osteosarcoma patient developed local recurrence and treated with below knee amputation. One Ewing’s sarcoma patient developed disseminated metastasis to the chest and skull.

Discussion and conclusions: The use of pasteurized bone graft for primary malignant bone tumors around the ankle indicated a satisfactory outcome regarding graft survival, complications, and functional results. A pasteurized autograft can be an easily accessible and efficient economical alternative for the usual reconstruction methods.