Comparison of flap reconstruction for soft tissue sarcomas of the foot and ankle

Abstract

Background: Foot and ankle soft tissue sarcomas (STS) are challenging for reconstruction due to limited surrounding soft tissue and weight-bearing requirements. Currently, there is a paucity of data examining the outcome of flap reconstruction following resection of a foot and ankle sarcoma.Methods: We reviewed 44 (31 female, 13 male) patients with STS arising from the ankle or foot which required coverage in the form of a free (n = 21), pedicled (n = 13), or rotational perforator flap (n = 10). The mean tumor size was 6 ± 5 cm, with 39 (89%) patients receiving radiotherapy. The mean follow-up was 10 ± 7 years.Results: There were no cases of amputation due to flap failure, with a 10-year limb salvage rate of 84%. Complications occurred in 19 (43%) patients, most commonly wound infections. There was no difference in the incidence of complications between patients undergoing a free flap and pedicled or perforator flap (odds ratio = 0.97, p = 1.0); with no difference in the mean Musculoskeletal Tumor Society (MSTS) score between patients with a free flap versus a pedicled/perforator flap (84% vs. 76%, p = 0.11). Conclusion:Flap reconstruction is an essential part of limb salvage for foot and ankle STS. At final follow-up nearly all the patients are ambulatory with an acceptable MSTS score.

What’s New in Musculoskeletal Tumor Surgery

“…Soft-tissue sarcomas arising from the hands and feet are a challenging entity given their anatomic considerations and continue to be an area of study 59,62 . Mallett et al reviewed 44 patients with foot and ankle soft-tissue sarcomas undergoing flap reconstructions 59 . They found a 10-year limb-salvage rate of 84%, with no differences in complications or functional outcomes between pedicled and free flaps.…”

“…Table II shows a number of recent studies on soft-tissue tumors [46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65] .…”

“…Soft-tissue sarcomas arising from the hands and feet are a challenging entity given their anatomic considerations and continue to be an area of study 59,62 . Mallett et al reviewed 44 patients with foot and ankle soft-tissue sarcomas undergoing flap reconstructions 59 .…”