Fig. 3.
Limb salvage surgery with reconstruction using free tissue transfer and adjuvant radiation therapy can yield excellent functional results, as demonstrated in this case of synovial sarcoma in a 21-year-old man. He was treated with neoadjuvant radiotherapy then resection with reconstruction of the first ray using a free vascularized fibular graft with an island of skin. (A) T2-weighted magnetic resonance image shows the lesion involving the first metataso–cuneiform joint (arrow). (B) Radiograph taken 3 years after surgery. (C) Photograph taken at 3-year follow-up showing good plantar flexion and excellent strength.