Objective:

To present a case of Ewing sarcoma of the calcaneus treated with total calcanectomy and reconstruction using a 3D-printed cement spacer, highlighting the surgical approach and outcomes.

Approach:

• Case Presentation: A 19-year-old female with a nonmetastatic calcaneal Ewing sarcoma underwent neoadjuvant chemotherapy followed by limb salvage total calcanectomy and reconstruction with a 3D-printed PMMA cement spacer.
• Surgical Technique: Reconstruction involved a custom-made 3D-printed mold for an antibiotic-impregnated PMMA cement spacer, secured with cannulated screws.

Key Findings:

• The patient experienced tumor regression after neoadjuvant chemotherapy.
• Post-surgery, the patient developed wound dehiscence requiring a free radial forearm flap for reconstruction.
• At 1-year follow-up, the patient ambulated with a cane and achieved a Toronto Extremity Salvage Score of 62.5%.
• A deep surgical site infection occurred at 2.5 years, which was managed by irrigation, debridement, and implant removal.

Interpretation:

This case illustrates the application of limb salvage surgery for calcaneal Ewing sarcoma using a 3D-printed reconstruction technique.

Limitations:

• The findings are based on a single patient report, which limits the generalizability of the results.
• The management of infection required multiple interventions, indicating potential complications associated with the procedure.

Conclusion:

This case demonstrates the use of 3D-printed prosthetic implants in limb salvage surgery for malignant bone tumors.