Limb Salvage in Secondary Chondrosarcoma of the Metatarsus

Malignant transformation of metatarsal osteochondroma into chondrosarcoma is a rare entity. The most optimal line of treatment, salvage procedure or amputation, continues to be debated. Both of these treatments have varied in popularity. We report the case of a 24-year-old male with chondrosarcoma secondary to differentiation of an osteochondroma in the second and third metatarsals. Wide resection of the tumor mass and reconstruction of the second and third metatarsals was performed using a simple and biologic approach. This was accomplished with an autologous nonvascularized fibular graft to reconstruct the longitudinal arch of the foot. The foot was successfully salvaged, with good anatomic, functional, and aesthetic results. At 1 year postoperatively, the patient was able to walk without any orthotic devices and had returned to his routine work. No evidence of local recurrence or metastasis was observed.