Single-Stage Reconstruction with Innate Chimeric-Free Fibula Flap in Limb-Preserving Excision of Upper Limb Sarcomas

Area of Science:

• Orthopedics
• Surgical Oncology
• Plastic Surgery

Background:

• Limb-preserving excision is standard for upper limb sarcomas, often creating complex defects.
• Reconstructing these defects demands specialized surgical expertise.

Purpose of the Study:

• To evaluate a novel single-stage reconstruction method for complex upper limb defects.
• To assess the efficacy of the innate chimeric-free fibula flap in sarcoma management.

Main Methods:

• Twenty patients with upper extremity sarcoma underwent wide local excision and reconstruction with an innate chimeric-free fibula flap.
• Follow-up averaged 18.3 months, with outcomes assessed using the Musculoskeletal Tumor Society (MSTS) score.

Main Results:

• The innate chimeric-free fibula flap successfully reconstructed skeletal, muscle-tendon, nerve, and cutaneous defects in a single stage.
• All flaps survived, leading to good hand function and an average MSTS score of 22 (p=0.035).

Conclusions:

• The innate chimeric-free fibula flap offers a versatile solution for complex upper limb defects.
• This single-stage reconstruction approach facilitates good functional outcomes, including restoration of hand function.