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Operative procedures on the lower limb demand crucial handling of the surrounding soft tissues. Otherwise skin necrosis may develop and in cases of overlapping to the bone there is a risk of osteitis. Therefore the operative treatment requires an approach which reduces operative trauma to a minimum. However, in some cases even a minimal incision is too traumatic. The case we present, describes the use of an expandable nail-system to correct a valgus deformity in a lower limb, years after radiation therapy for synovial sarcoma. The distinctiveness in this case is the dystrophic skin after irradiation and the surgical options for correction.