Intraoperative difficulties during management of proximal fibular tumors: A case series

Abstract

Proximal fibular tumors are treated by en bloc excision and lateral collateral ligament (LCL) repair. Intraoperative injury to the popliteal artery or its trifurcation, common peroneal nerve, and LCL can occur. Three cases of giant cell tumor and one case of exostosis of proximal fibula were analyzed. Apart from routine tests, preoperative computed tomography angiography (CTA) was done in two cases. Vascular injury was seen in two cases where CTA was not done, while in others, it was safe. Foot drop was seen in one case due to peroneal nerve resection. None of the patients developed varus instability even without LCL repair. Authors suggest preoperative CTA in all tumors of proximal fibula for preoperative planning, counseling of patients, vascular consultation, and to prevent complications.

Keywords

• computed tomography angiography
• exostosis
• giant cell tumor
• popliteal artery
• proximal fibula