Figure 2a – radiograph of a 13-year-old girl with a painless lump over her right elbow. Investigation showed it to be a parosteal osteosarcoma involving the medullary canal. The tumour was resected 1 cm from the elbow joint and 12 cm more proximal. The tumour was removed and the medullary canal cleaned. The bone was then sterilised with 90 Gy of radiotherapy. Figure 2b – photograph of a non-vascularised fibular graft which was inserted in the middle of the bone, the construct being replaced with two supporting plates. Within six months the patient had returned to netball and had a full range of movement of the elbow. Figure 2c – radiograph at ten years shows a very satisfactory outcome.