Limb salvage with microvascular free fibula following primary bone sarcoma resection

Background: Extremity sarcomas are challenging to manage. Total eradication of tumour has to be balanced with restoration of limb function to prevent mortality and morbidity. Disease-free survival with maximum limb function is the ultimate goal in these patients. Materials and Methods: We present a...

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Main Authors: Sahasrabudhe Parag, Panchwagh Yogesh, Jesal Rathod, Panse Nikhil, Jadhav Amit
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2016-09-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.197244
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author Sahasrabudhe Parag
Panchwagh Yogesh
Jesal Rathod
Panse Nikhil
Jadhav Amit
author_facet Sahasrabudhe Parag
Panchwagh Yogesh
Jesal Rathod
Panse Nikhil
Jadhav Amit
author_sort Sahasrabudhe Parag
collection DOAJ
description Background: Extremity sarcomas are challenging to manage. Total eradication of tumour has to be balanced with restoration of limb function to prevent mortality and morbidity. Disease-free survival with maximum limb function is the ultimate goal in these patients. Materials and Methods: We present a series of ten cases of extremity malignancies, where limb salvage was attempted with microvascular free fibula for limb reconstruction from the period of 2008 to 2015. Results: Of the ten cases in the study, there were two females and eight males. There were nine patients with lower limb malignancies and one patient with upper limb malignancy. There were four patients with Ewing’s sarcoma of femur, five patients with osteosarcoma of femur and one patient with chondrosarcoma of the humerus. The follow-up period ranged from 1.2 to 6.2 years with mean follow-up of 3.1 years. There were two deaths during follow-up, both were due to distant metastasis. The assessment of the function was done on the basis of Musculoskeletal Tumour Society functional score. Maximum score was 30 and minimum score was 24, the average score being 26. Of the eight surviving patients, three patients had full weightbearing, four patients had partial weightbearing at end of 2 years and one patient of upper limb reconstruction had complete upper limb function. None of the patients had to undergo limb amputation. Conclusion: Limb salvage with vascularised fibula graft offers good functional outcome along with good disease-free survival rates.
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spelling doaj-art-1ebc2952ad364200b750dfd74dd5f5cc2025-08-20T02:03:47ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2016-09-01490337037710.4103/0970-0358.197244Limb salvage with microvascular free fibula following primary bone sarcoma resectionSahasrabudhe Parag0Panchwagh Yogesh1Jesal Rathod2Panse Nikhil3Jadhav Amit4Department of Plastic Surgery, B.J. Government Medical College and Sassoon General Hospitals, Pune, Maharashtra, IndiaDepartment of Plastic Surgery, Deenanath Hospital, Pune, Maharashtra, IndiaDepartment of Plastic Surgery, Deenanath Hospital, Pune, Maharashtra, IndiaDepartment of Plastic Surgery, B.J. Government Medical College and Sassoon General Hospitals, Pune, Maharashtra, IndiaDepartment of Plastic Surgery, Deenanath Hospital, Pune, Maharashtra, IndiaBackground: Extremity sarcomas are challenging to manage. Total eradication of tumour has to be balanced with restoration of limb function to prevent mortality and morbidity. Disease-free survival with maximum limb function is the ultimate goal in these patients. Materials and Methods: We present a series of ten cases of extremity malignancies, where limb salvage was attempted with microvascular free fibula for limb reconstruction from the period of 2008 to 2015. Results: Of the ten cases in the study, there were two females and eight males. There were nine patients with lower limb malignancies and one patient with upper limb malignancy. There were four patients with Ewing’s sarcoma of femur, five patients with osteosarcoma of femur and one patient with chondrosarcoma of the humerus. The follow-up period ranged from 1.2 to 6.2 years with mean follow-up of 3.1 years. There were two deaths during follow-up, both were due to distant metastasis. The assessment of the function was done on the basis of Musculoskeletal Tumour Society functional score. Maximum score was 30 and minimum score was 24, the average score being 26. Of the eight surviving patients, three patients had full weightbearing, four patients had partial weightbearing at end of 2 years and one patient of upper limb reconstruction had complete upper limb function. None of the patients had to undergo limb amputation. Conclusion: Limb salvage with vascularised fibula graft offers good functional outcome along with good disease-free survival rates.http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.197244bone sarcomalimb salvagevascularised fibula flap
spellingShingle Sahasrabudhe Parag
Panchwagh Yogesh
Jesal Rathod
Panse Nikhil
Jadhav Amit
Limb salvage with microvascular free fibula following primary bone sarcoma resection
Indian Journal of Plastic Surgery
bone sarcoma
limb salvage
vascularised fibula flap
title Limb salvage with microvascular free fibula following primary bone sarcoma resection
title_full Limb salvage with microvascular free fibula following primary bone sarcoma resection
title_fullStr Limb salvage with microvascular free fibula following primary bone sarcoma resection
title_full_unstemmed Limb salvage with microvascular free fibula following primary bone sarcoma resection
title_short Limb salvage with microvascular free fibula following primary bone sarcoma resection
title_sort limb salvage with microvascular free fibula following primary bone sarcoma resection
topic bone sarcoma
limb salvage
vascularised fibula flap
url http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.197244
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AT jesalrathod limbsalvagewithmicrovascularfreefibulafollowingprimarybonesarcomaresection
AT pansenikhil limbsalvagewithmicrovascularfreefibulafollowingprimarybonesarcomaresection
AT jadhavamit limbsalvagewithmicrovascularfreefibulafollowingprimarybonesarcomaresection