The authors report 12 cases of bone tumors localized in the distal tibia treated by resection and reconstruction with ankle arthrodesis, using bone grafts and fixation with Kuntscher or Grosse-Kempf nail or plate. In seven cases autografts were used, and in five cases autografts combined with allografts were used. In three of these five patients, a vascularized fibula combined with a "gutter-like" allograft was used to reconstruct the bone defect. In all cases, the functional and oncologic results were good and all patients were disease free at an average follow-up of 68 months.