Chondromyxoid Fibroma of the Metatarsals: Outcomes of En Bloc Resection and Intercalary Fibular Allograft Reconstruction in a Series of 9 Patients.

BackgroundThe optimal surgical and reconstructive strategies for chondromyxoid fibroma (CMF) of the metatarsal bones remain controversial. This study examined the outcomes of en bloc resection followed by fibular strut allograft reconstruction in 9 patients with aggressive or recurrent metatarsal CMF.MethodsNine patients were included in this retrospective case series. Indications for this approach included thin cortex, cortical breakdown, or local recurrence. Outcomes were recurrence, radiographic union, limb function, and surgical complications.ResultsAt a median follow-up of 8 years, no local recurrence was recorded in this series. Radiographic union at both host-allograft junctions was achieved in 8 of 9 patients. The median Musculoskeletal Tumor Society score was 30. The median Toronto Extremity Salvage Score was 96. Complications were infrequent and manageable.ConclusionEn bloc resection followed by fibular strut allograft reconstruction appears to provide durable local tumor control and encouraging functional outcomes in patients with aggressive or locally recurrent metatarsal CMF.Level of Evidence:IV (Therapeutic study; case series.