Immediate Tendon Transfer for Functional Reconstruction in Upper Limb Sarcoma Surgery: An Observational Study

Area of Science:

• Orthopedic Surgery
• Surgical Oncology
• Reconstructive Surgery

Background:

• Upper limb sarcoma surgery often necessitates sacrificing major nerves, leading to substantial functional deficits.
• Microsurgical reconstruction options are frequently limited in low-resource settings.
• Immediate tendon transfer presents a viable alternative for functional restoration in these scenarios.

Purpose of the Study:

• To evaluate the functional outcomes of immediate tendon transfer in patients undergoing nerve-sacrificing sarcoma excision of the upper limb.
• To assess the efficacy of this reconstructive strategy in improving limb function post-oncologic surgery.

Main Methods:

• A multicentric observational study was conducted across four tertiary centers in Nepal.
• 14 patients undergoing upper limb sarcoma surgery with immediate tendon transfer between January 2021 and May 2024 were included.
• Functional outcomes were assessed using Quick DASH, Musculoskeletal Tumor Society (MSTS) scores, and Medical Research Council (MRC) grading.

Main Results:

• The mean Quick DASH score improved significantly from 85.17 at 6 weeks to 11.95 at 12 months post-surgery.
• The mean MSTS score increased from 8.57 to 25.71 over the same period.
• All patients achieved an MRC grading of >4 at the 12-month follow-up, indicating good motor recovery.

Conclusions:

• Immediate tendon transfer is a highly effective reconstructive strategy following nerve sacrifice in upper limb sarcoma surgery.
• This approach provides a practical and successful method for restoring limb function, particularly in resource-limited environments.