Tsuda Y, et al. - Eighteen children aged less than 16 years old who underwent resection of bone sarcomas, leaving ≤ 5 cm of bone from the physis, and reconstruction with a custom-made endoprosthesis between 2007 and 2017 was analyzed in order to report the outcomes of custom-made endoprostheses with extracortical plates plus or minus a short, intramedullary stem intended to preserve the physis following resection of bone sarcomas in children. The five-year overall survival rate was 78%. Local recurrence was not noted in any patient. The five-year implant survival rate was 79%. Eleven patients in all, acquired a complication. In order to to treat the complications, seven patients needed further surgery . Implant failures happened in three patients comprising one patient with aseptic loosening and two patients with implant or periprosthetic fracture. The preserved physis persisted to grow at mean 3.3 cm. The mean Musculoskeletal Society score was 88%. Therefore, custom-made endoprostheses that target to preserve the physis are a safe and efficient option for preserving physeal growth, limb length, and joint function with an acceptable rate of complications.