Despite advancements in improving overall survival rates and quality of life through limb preservation, long-term follow-up data is limited. Herein, we present three cases of pediatric upper arm malignant tumors treated with wide resection and free fibula graft reconstruction, with a follow-up period of over nine years. We retrospectively examine the diagnoses, surgical techniques, and postoperative functions. Although bone elongation after flap transplantation cannot be guaranteed, all three patients were able to perform daily activities independently. Postoperative fractures were observed in two cases.
