Resection of malignant tumors about the knee, followed by reconstruction of the lower limb by rotating it through an arc of 180 degrees is becoming a popular method of treatment of osteosarcoma in growing children. Following rotation, the rotated ankle functions as the knee joint, powering a custom‐made prosthesis. The functional result is superior to above‐knee amputation with better propioceptive feedback and the absence of phantom limb pain. The children are able to climb stairs well and participate in running sports. The surgical technique is demanding, requiring a precise knowledge of the surgical anatomy. To be successful, the sciatic, peroneal, and tibial nerves must be preserved. The femoral and popliteal artery may be resected and reconstructed if necessary. The remaining growth of the child is determined so that the rotated ankle can be positioned at the level of the contralateral normal knee.
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