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Published on: August 15, 2019
Free functional muscle transfer after oncologic extremity reconstruction: A systematic review
Liahm Blank1, Joshua Khorsandi1, Hailey Kim1
1Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas, 625 Shadow Ln, Las Vegas, NV 89106, USA.
JPRAS Open
|May 28, 2026
Summary
Free functional muscle transfer (FFMT) offers reliable limb salvage after sarcoma surgery, restoring significant motor function. Further research is needed to standardize outcomes and improve functional recovery data.
Area of Science:
- Orthopedic Surgery
- Microsurgery
- Reconstructive Surgery
Background:
- Limb-salvage surgery for extremity sarcoma aims to preserve function, but resections often cause severe disability.
- Free functional muscle transfer (FFMT) is a reconstructive option using microvascular surgery to restore active motion.
Purpose of the Study:
- To systematically review the outcomes of FFMT after oncologic extremity resection.
- To evaluate flap survival, functional strength recovery, complications, and tumor recurrence.
Main Methods:
- A PRISMA-guided systematic review of 22 studies (82 cases) was conducted.
- Outcomes were synthesized using pooled proportions with Wilson 95% confidence intervals.
Main Results:
- 100% flap survival (77/77) was observed.
- A pooled complication rate of 26.67% (16/60) was reported, primarily wound-related.
- 43.9% of cases achieved MRC/MMT strength >3 to ≤4, and 15.9% achieved >4 to ≤5.
Conclusions:
- FFMT is a reliable technique for functional limb salvage after extremity sarcoma resection, providing meaningful strength recovery.
- The current evidence is limited by small, heterogeneous studies, highlighting the need for standardized functional endpoints and prospective data.
