After resection of a malignant tumour, the options for reconstruction include the use of massive allografts. The potential benefits of allografts include the ability to shape the graft to match the defect at the time of surgery and high rates of union in metaphyseal bone. The options for fixation of allografts include intramedullary nails and plating.

The AO-LISS DF (less invasive stabilisation system for the distal femur) is a new plate designed for fractures of the femur. The screws lock into the plate and the system is thought to provide excellent purchase in metaphyseal bone. A jig allows percutaneous screw insertion.

We describe a case in which a 28 year old woman with a high grade sarcoma of the distal femur underwent reconstruction using an intercalated allograft and two LISS-DF plates. This technique allowed the knee joint to be preserved. Although the surgical approach to the femur was medial, the LISS-DF jig allowed a plate to be placed on the lateral side of the femur in a “less invasive” fashion. Although the plate is designed for application to the lateral side of the femur, in this case adequate fit on the medial side was obtained with a plate from the contralateral limb. This reconstruction provided excellent early stability at the junctions between host and allograft bone.