Skip to main content

Extremity Reconstruction

  • Chapter
  • 1541 Accesses

Abstract

Extremity tumors are predominantly of musculoskeletal origin. Of these, soft-tissue sarcomas (STS) are more common than the bone sarcomas. STS comprise approximately 1% of all adult malignancies and 15% of all pediatric malignancies (1). There are approximately 8700 new cases of STS diagnosed in the United States per year compared to 2900 cases of bone cancers (predominantly osteosarcoma and chondrosarcoma) (2). The deficits that result from resection of these tumors are often large and need extensive reconstructive surgery.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Khatri VP, Goodnight JE Jr. Extremity soft tissue sarcoma: controversial management issues. Surg Oncol 2005;14:1–9.

    PubMed  Google Scholar 

  2. Greenlee RT, Hill-Harmon MB, Murray T, Thun M. Cancer statistics, 2001. CA Cancer J Clin 2001;51:15–36.

    CAS  PubMed  Google Scholar 

  3. Panicek DM, Gatsonis C, Rosenthal DI, et al. CT and MR imaging in the local staging of primary malignant musculoskeletal neoplasms: report of the Radiology Diagnostic Oncology Group Radiology. 1997;202:237–246.

    CAS  Google Scholar 

  4. Mankin HJ, Mankin CJ, Simon MA. The hazards of the biopsy, revisited. Members of the Musculoskeletal Tumor Society. J Bone Joint Surg Am 1996;78:656–663.

    CAS  PubMed  Google Scholar 

  5. Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res 1980;153:106–120.

    PubMed  Google Scholar 

  6. Enneking WF, Spanier SS, Goodman MA. Current concepts review. The surgical staging of musculoskeletal sarcoma. J Bone Joint Surg Am 1980;62:1027–1030.

    CAS  PubMed  Google Scholar 

  7. Sadoski C, Suit HD, Rosenberg A, Mankin H, Efird J. Preoperative radiation, surgical margins, and local control of extremity sarcomas of soft tissues. J Surg Oncol 1993;52:223–230.

    CAS  PubMed  Google Scholar 

  8. Rosenberg SA, Tepper J, Glatstein E, et al. The treatment of soft-tissue sarcomas of the extremities: prospective randomized evaluations of (1) limb-sparing sur gery plus radiation therapy compared with amputation and (2) the role of adjuvant chemotherapy. Ann Surg 1982;196:305–315.

    CAS  PubMed  Google Scholar 

  9. Fagundes HM, Lai PP, Dehner LP, et al. Postoperative radiotherapy for malignant fibrous histiocytoma. Int J Radiat Oncol Biol Phys 1992;23: 615–619.

    CAS  PubMed  Google Scholar 

  10. LeVay J, O’Sullivan B, Catton C, et al. Outcome and prognostic factors in soft tissue sarcoma in the adult. Int J Radiat Oncol Biol Phys 1993;27:1091–1099.

    CAS  PubMed  Google Scholar 

  11. Tanabe KK, Pollock RE, Ellis LM, Murphy A, Sherman N, Romsdahl MM. Influence of surgical margins on outcome in patients with preoperatively irradiated extremity soft tissue sarcomas. Cancer 1994;73:1652–1659.

    CAS  PubMed  Google Scholar 

  12. Potter DA, Kinsella T, Glatstein E, et al. High-grade soft tissue sarcomas of the extremities. Cancer 1986;58:190–205.

    CAS  PubMed  Google Scholar 

  13. McKee MD, Liu DF, Brooks JJ, Gibbs JF, Driscoll DL, Kraybill WG. The prognostic significance of margin width for extremity and trunk sarcoma. J Surg Oncol 2004;85:68–76.

    PubMed  Google Scholar 

  14. Kawaguchi N, Ahmed AR, Matsumoto S, Manabe J, Matsushita Y. The concept of curative margin in surgery for bone and soft tissue sarcoma. Clin Orthop Relat Res 2004;419:165–172.

    PubMed  Google Scholar 

  15. Dürr HR, Jansson V, Jauch KW, et al. Operative Therapie Von Knochen-Und Weichteiltumoren. In: Tumorzentrum München (ed.), Manual: Knochentumoren und Weichteilsarkome, fourth edition. München: W. Zuckschwerdt Verlag; 2004.

    Google Scholar 

  16. Williard WC, Hajdu SI, Casper ES, Brennan MF. Comparison of amputation with limb-sparing operations for adult soft tissue sarcoma of the extremity. Ann Surg 1992;215:269–275.

    CAS  PubMed  Google Scholar 

  17. Grimer RJ, Taminiau AM, Cannon SR. Surgical outcomes in osteosarcoma. J Bone Joint Surg Br 2002;84:395–400.

    CAS  PubMed  Google Scholar 

  18. Collin C, Godbold J, Hajdu S, Brennan M. Localized extremity soft tissue sarcoma: an analysis of factors affecting survival. J Clin Oncol 1987;5:601–612.

    CAS  PubMed  Google Scholar 

  19. Lewis JJ, Leung D, Heslin M, Woodruff JM, Brennan MF. Association of local recurrence with subsequent survival in extremity soft tissue sarcoma. J Clin Oncol 1997;15:646–652.

    CAS  PubMed  Google Scholar 

  20. Markhede G, Angervall L, Stener B. A multivariate analysis of the prognosis after surgical treatment of malignant soft-tissue tumors. Cancer 1982;49:1721–1733.

    CAS  PubMed  Google Scholar 

  21. Brennan MF, Hilaris B, Shiu MH, et al. Local recurrence in adult soft-tissue sarcoma. A randomized trial of brachytherapy. Arch Surg 1987;122:1289–1293.

    CAS  PubMed  Google Scholar 

  22. Trovik CS, Bauer HC, Alvegard TA, et al. Surgical margins, local recurrence and metastasis in soft tissue sarcomas: 559 surgically-treated patients from the Scandinavian Sarcoma Group Register. Eur J Cancer 2000;36:710–716.

    CAS  PubMed  Google Scholar 

  23. Ueda T, Yoshikawa H, Mori S, et al. Influence of local recurrence on the prognosis of soft-tissue sarcomas. J Bone Joint Surg Br 1997;79:553–557.

    CAS  PubMed  Google Scholar 

  24. Gaynor JJ, Tan CC, Casper ES, et al. Refinement of clinicopathologic staging for localized soft tissue sarcoma of the extremity: a study of 423 adults. J Clin Oncol 1992;10:1317–1329.

    CAS  PubMed  Google Scholar 

  25. Ramanathan RC, A’Hern R, Fisher C, Thomas JM. Prognostic index for extremity soft tissue sarcomas with isolated local recurrence. Ann Surg Oncol 2001;8:278–289.

    CAS  PubMed  Google Scholar 

  26. Renard AJ, Veth RP, Schreuder HW, van Loon CJ, Koops HS, van Horn JR. Function and complications after ablative and limb-salvage therapy in lower extremity sarcoma of bone. J Surg Oncol 2000;73:198–205.

    CAS  PubMed  Google Scholar 

  27. Refaat Y, Gunnoe J, Hornicek FJ, Mankin HJ. Comparison of quality of life after amputation or limb salvage. Clin Orthop Relat Res 2002;397:298–305.

    PubMed  Google Scholar 

  28. Zahlten-Hinguranage A, Bernd L, Ewerbeck V, Sabo D. Equal quality of life after limb-sparing or ablative surgery for lower extremity sarcomas. Br J Cancer 2004;91:1012–1014.

    CAS  PubMed  Google Scholar 

  29. Nagarajan R, Neglia JP, Clohisy DR, Robison LL. Limb salvage and amputation in survivors of pediatric lower-extremity bone tumors: what are the long-term implications? J Clin Oncol 2002;20:4493–4501.

    PubMed  Google Scholar 

  30. Postma A, Kingma A, De Ruiter JH, et al. Quality of life in bone tumor patients comparing limb salvage and amputation of the lower extremity. J Surg Oncol 1992;51:47–51.

    CAS  PubMed  Google Scholar 

  31. Fayers PM, Aaronson NK, Bjordal K, et al. The EORTC QLQ-C30 Scoring Manual, third edition. Brussels: 2001.

    Google Scholar 

  32. Fahrenberg J, Myrtek M, Schumacher J, Brähler E. Fragebogen zur Lebenszufriedenheit (FLZ)-Handanweisung. Göttingen: 2000.

    Google Scholar 

  33. Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res 1993;286:241–246.

    PubMed  Google Scholar 

  34. Davis AM, Devlin M, Griffin AM, Wunder JS, Bell RS. Functional outcome in amputation versus limb sparing of patients with lower extremity sarcoma: a matched case-control study. Arch Phys Med Rehabil 1999;80:615–618.

    CAS  PubMed  Google Scholar 

  35. Sugarbaker PH, Barofsky I, Rosenberg SA, Gianola FJ. Quality of life assessment of patients in extremity sarcoma clinical trials. Surgery 1982;91:17–23.

    CAS  PubMed  Google Scholar 

  36. Hudson MM, Tyc VL, Cremer LK, et al. Patient satisfaction after limb-sparing surgery and amputation for pediatric malignant bone tumors. J Pediatr Oncol Nurs 1998;15:60–69.

    CAS  PubMed  Google Scholar 

  37. Weddington WW Jr, Segraves KB, Simon MA. Psychological outcome of extremity sarcoma survivors undergoing amputation or limb salvage. J Clin Oncol 1985;3:1393–1399.

    PubMed  Google Scholar 

  38. Ghert MA, Abudu A, Driver N, et al. The indications for and the prognostic significance of amputation as the primary surgical procedure for localized soft tissue sarcoma of the extremity. Ann Surg Oncol 2005;12:10–17.

    PubMed  Google Scholar 

  39. Cordeiro PG, Neves RI, Hidalgo DA. The role of free tissue transfer following oncologic resection in the lower extremity. Ann Plast Surg 1994;33:9–16.

    CAS  PubMed  Google Scholar 

  40. Lohman RF, Nabawi AS, Reece GP, Pollock RE, Evans GR. Soft tissue sarcoma of the upper extremity: a 5-year experience at two institutions emphasizing the role of soft tissue flap reconstruction. Cancer 2002;94:2256–2264.

    PubMed  Google Scholar 

  41. Van Landuyt K, Hamdi M, Blondeel P, Tonnard P, Verpaele A, Monstrey S. Free perforator flaps in children. Plast Reconstr Surg 2005;116:159–169.

    PubMed  Google Scholar 

  42. Haninec P, Smrcka V. Reconstruction of paralyzed biceps brachii muscle by transposition of pedicled latissimus dorsi muscle: report of two cases. Acta Chir Plast 1998;40:41–44.

    CAS  PubMed  Google Scholar 

  43. Mailander P, Machens HG, Rieck B, Wittig K, Berger A. [Bilateral biceps replacement-plasty by transposition of the latissimus dorsi muscle in arthrogryposis multiplex congenita. A case report]. Handchir Mikrochir Plast Chir 1996;28:59–63.

    CAS  PubMed  Google Scholar 

  44. Willcox TM, Smith AA, Beauchamp C, Meland NB. Functional free latissimus dorsi muscle flap to the proximal lower extremity. Clin Orthop Relat Res 2003;410:285–288.

    PubMed  Google Scholar 

  45. Park C, Shin KS. Functioning free latissimus dorsi muscle transplantation: anterogradely positioned usage in reconstruction of extensive forearm defect. Ann Plast Surg 1991;27:87–91.

    CAS  PubMed  Google Scholar 

  46. Uhm KI, Shin KS, Lee YH, Lew JD. Restoration of finger extension and forearm contour utilizing a neurovascular latissimus dorsi free flap. Ann Plast Surg 1988;21:74–76.

    CAS  PubMed  Google Scholar 

  47. Krimmer H, Hahn P, Lanz U. Free gracilis muscle transplantation for hand reconstruction. Clin Orthop Relat Res 1995;314:13–18.

    PubMed  Google Scholar 

  48. Erdmann D, Bergquist GE, Levin LS. Ipsilateral free fibula transfer for reconstruction of a segmental femoral-shaft defect. Br J Plast Surg 2002;55:675–677.

    CAS  PubMed  Google Scholar 

  49. Erdmann D, Giessler GA, Bergquist GE, et al. [Free fibula transfer. Analysis of 76 consecutive microsurgical procedures and review of the literature]. Chirurg 2004;75:799–809.

    CAS  PubMed  Google Scholar 

  50. Georgescu AV, Ivan O. Serratus anterior-rib free flap in limb bone reconstruction Microsurgery 2003;23:217–225.

    PubMed  Google Scholar 

  51. de Boer HH, Wood MB. Bone changes in the vascularised fibular graft. J Bone Joint Surg Br 1989;71:374–378.

    PubMed  Google Scholar 

  52. Heitmann C, Erdmann D, Levin LS. Treatment of segmental defects of the humerus with an osteoseptocutaneous fibular transplant. J Bone Joint Surg Am 2002;84-A:2216–2223.

    CAS  PubMed  Google Scholar 

  53. Park S, Lee TJ. Strategic considerations on the configuration of free flaps and their vascular pedicles combined with Ilizarov distraction in the lower extremity. Plast Reconstr Surg 2000;105:1680–1686.

    CAS  PubMed  Google Scholar 

  54. Carrington NC, Smith RM, Knight SL, Matthews SJ. Ilizarov bone transport over a primary tibial nail and free flap: a new technique for treating Gustilo grade 3b fractures with large segmental defects. Injury 2000;31:112–115.

    CAS  PubMed  Google Scholar 

  55. Gugenheim JJ Jr. The Ilizarov method. Orthopedic and soft tissue applications. Clin Plast Surg 1998;25:567–578.

    PubMed  Google Scholar 

  56. Levin LS. The ilizarov method and microsurgery: the best of both worlds. Am Soc Reconstr Microsurg Newsl 1995;2:23–24.

    Google Scholar 

  57. Ortiz-Cruz E, Gebhardt MC, Jennings LC, Springfield DS, Mankin HJ. The results of transplantation of intercalary allografts after resection of tumors. A long-term follow-up study. J Bone Joint Surg Am 1997;79:97–106.

    CAS  PubMed  Google Scholar 

  58. Mankin HJ, Springfield DS, Gebhardt MC, Tomford WW. Current status of allografting for bone tumors. Orthopedics 1992;15:1147–1154.

    CAS  PubMed  Google Scholar 

  59. Sim FH, Beauchamp CP, Chao EY. Reconstruction of musculoskeletal defects about the knee for tumor. Clin Orthop Relat Res 1987;221:188–201.

    PubMed  Google Scholar 

  60. Ward WG, Yang R-S, Eckardt JJ. Endoprosthetic bone reconstruction following malignant tumor resection in skeletally immature patients. Orthop Clin North Am 1996;27:493–502.

    CAS  PubMed  Google Scholar 

  61. Bunkis J, Walton RL, Mathes SJ. The rectus abdominis free flap for lower extremity reconstruction. Ann Plast Surg 1983;11:373–380.

    CAS  PubMed  Google Scholar 

  62. Mastorakos DP, Disa JJ, Athanasian E, Boland P, Healey JH, Cordeiro PG. Soft-tissue flap coverage maximizes limb salvage after allograft bone extremity reconstruction. Plast Reconstr Surg 2002;109:1567–1573.

    PubMed  Google Scholar 

  63. Chang DW, Weber KL. Segmental femur reconstruction using an intercalary allograft with an intramedullary vascularized fibula bone flap. J Reconstr Microsurg 2004;20:195–199.

    CAS  PubMed  Google Scholar 

  64. Hou SM, Liu TK. Reconstruction of skeletal defects in the femur with “two-strut” free vascularized fibular grafts. J Trauma 1992;33:840–845.

    CAS  PubMed  Google Scholar 

  65. Ceruso M, Falcone C, Innocenti M, Delcroix L, Capanna R, Manfrini M. Skeletal reconstruction with a free vascularized fibula graft associated to bone allograft after resection of malignant bone tumor of limbs. Handchir Mikrochir Plast Chir 2001;33:277–282.

    CAS  PubMed  Google Scholar 

  66. Schwarzbach MH, Hormann Y, Hinz U, et al. Results of limb-sparing surgery with vascular replacement for soft tissue sarcoma in the lower extremity. J Vase Surg 2005;42:88–97.

    Google Scholar 

  67. Fuchs B, Davis AM, Wunder JS, et al. Sciatic nerve resection in the thigh: a functional evaluation. Clin Orthop Relat Res 2001;382:34–41.

    PubMed  Google Scholar 

  68. Donati D, Giacomini S, Gozzi E, et al. Allograft arthrodesis treatment of bone tumors: a two-center study. Clin Orthop Relat Res 2002;400:217–224.

    PubMed  Google Scholar 

  69. Zenn MR, Levin LS. Microvascular reconstruction of the lower extremity. Semin Surg Oncol 2000;19:272–281.

    CAS  PubMed  Google Scholar 

  70. Erdmann D, Sundin BM, Yasui K, Wong MS, Levin LS. Microsurgical free flap transfer to amputation sites: indications and results. Ann Plast Surg 2002;48:167–172.

    PubMed  Google Scholar 

  71. Kuntscher MV, Erdmann D, Homann HH, Steinau HU, Levin SL, Germann G. The concept of fillet flaps: classification, indications, and analysis of their clinical value. Plast Reconstr Surg 2001;108:885–896.

    CAS  PubMed  Google Scholar 

  72. Kuntscher MV, Erdmann D, Strametz S, Sauerbier M, Germann G, Levin LS. [The use of fillet flaps in upper extremity and shoulder reconstruction] Chirurg 2002;73:1019–1024.

    CAS  PubMed  Google Scholar 

  73. Wang HC, Lu YM, Chien SH, Lin GT, Lu CC. Rotationplasty for limb salvage in the treatment of malignant tumors: a report of two cases. Kaohsiung J Med Sci 2003;19:628–634.

    PubMed  Google Scholar 

  74. Hardes J, Gebert C, Hillmann A, Winkelmann W, Gosheger G. [Rotationplasty in the surgical treatment plan of primary malignant bone tumors. Possibilities and limits]. Orthopade 2003;32:965–970.

    CAS  PubMed  Google Scholar 

  75. Rodl RW, Pohlmann U, Gosheger G, Lindner NJ, Winkelmann W. Rotationplasty—quality of life after 10 years in 22 patients. Acta Orthop Scand 2002;73:85–88.

    Article  PubMed  Google Scholar 

  76. Tukiainen E, Biancari F, Lepantalo M. Lower limb revascularization and free flap transfer for major ischemic tissue loss. World J Surg 2000;24:1531–1536.

    CAS  PubMed  Google Scholar 

  77. Quinones-Baldrich WJ, Kashyap VS, Taw MB, et al. Combined revascularization and microvascular free tissue transfer for limb salvage: a six-year experience. Ann Vase Surg 2000;14:99–104.

    CAS  Google Scholar 

  78. Lorenzetti F, Tukiainen E, Alback A, Kallio M, Asko-Seljavaara S, Lepantalo M. Blood flow in a pedal bypass combined with a free muscle flap. Eur J Vase Endovasc Surg 2001;22:161–164.

    CAS  Google Scholar 

  79. Tseng WS, Chen HC, Hung J, Tasi TR, Chen HH, Wei FC. “Flow-through” type free flap for revascularization and simultaneous coverage of a nearly complete amputation of the foot: case report and literature review. J Trauma 2000;48:773–776.

    CAS  PubMed  Google Scholar 

  80. Ceruso M, Falcone C, Innocenti M, Delcroix L, Capanna R, Manfrini M. Skeletal reconstruction with a free vascularized fibula graft associated to bone allograft after resection of malignant bone tumor of limbs. Handchir Mikrochir Plast Chir 2001;33:277–282.

    CAS  PubMed  Google Scholar 

  81. Baumeister S, Germann G. Soft tissue coverage of the extremely traumatized foot and ankle. Foot Ankle Clin 2001;6:867–903, ix.

    CAS  PubMed  Google Scholar 

  82. Lange RH. Limb reconstruction versus amputation decision making in massive lower extremity trauma. Clin Orthop Relat Res 1989;243:92–99.

    PubMed  Google Scholar 

  83. Heller L, Levin LS. Lower extremity microsurgical reconstruction. Plast Reconstr Surg 2001;108:1029–1041.

    CAS  PubMed  Google Scholar 

  84. Langstein HN, Chang DW, Miller MJ, et al. Limb salvage for soft-tissue malignancies of the foot: an evaluation of free-tissue transfer. Plast Reconstr Surg 2002;109:152–159.

    PubMed  Google Scholar 

  85. Gaulke R, Partecke B-D. Nachuntersuchung und Gandstudie bei Patienten mit plastisch-chirurgisch gedeckten Fubsohlendefekten Unfallchirurg 1994;97:47–53.

    CAS  PubMed  Google Scholar 

  86. Noever G, Bruser P, Kohler L. Reconstruction of heel and sole defects by free flaps. Plast Reconstr Surg 1986;78:345–352.

    Article  CAS  PubMed  Google Scholar 

  87. Goldberg JA, Adkins P, Tsai TM. Microvascular reconstruction of the foot: weight-bearing patterns, gait analysis, and long-term follow-up. Plast Reconstr Surg 1993;92:904–911.

    CAS  PubMed  Google Scholar 

  88. Santanelli F, Tenna S, Pace A, Scuderi N. Free flap reconstruction of the sole of the foot with or without sensory nerve coaptation. Plast Reconstr Surg 2002;109:2314–2322.

    PubMed  Google Scholar 

  89. Sommerlad BC, McGrouther DA. Resurfacing the sole: long-term follow-up and comparison of techniques. Br J Plast Surg 1978;31:107–116.

    CAS  PubMed  Google Scholar 

  90. Rautio J, Kekoni J, Hamalainen H, Harma M, Asko-Seljavaara S. Mechanical sensibility in free and island flaps of the foot. J Reconstr Microsurg 1989;5:119–125.

    CAS  PubMed  Google Scholar 

  91. Lahteenmaki T, Waris T, Asko-Seljavaara S, Sundell B. Recovery of sensation in free flaps. Scand J Plast Reconstr Surg Hand Surg 1989;23:217–222.

    CAS  PubMed  Google Scholar 

  92. Sinha AK, Wood MB, Irons GB. Free tissue transfer for reconstruction of the weight-bearing portion of the foot. Clin Orthop Relat Res 1989;242:269–271.

    PubMed  Google Scholar 

  93. Potparic Z, Rajacic N. Long-term results of weight-bearing foot reconstruction with non-innervated and reinnervated free flaps. Br J Plast Surg 1997;50:176–181.

    CAS  PubMed  Google Scholar 

  94. Fuchs B, O’Connor MI, Padgett DJ, Kaufman KR, Sim FH. Arthrodesis of the shoulder after tumor resection. Clin Orthop Relat Res 2005;436:202–207.

    PubMed  Google Scholar 

  95. Kassab M, Dumaine V, Babinet A, Ouaknine M, Tomeno B, Anract P. [Twenty nine shoulder reconstructions after resection of the proximal humerus for neoplasm with mean 7-year follow-up]. Rev Chir Orthop Reparatrice Appar Mot 2005;91:15–23.

    CAS  PubMed  Google Scholar 

  96. Amin SN, Ebeid WA. Shoulder reconstruction after tumor resection by pedicled scapular crest graft. Clin Orthop Relat Res 2002;397:133–142.

    PubMed  Google Scholar 

  97. Sandy G, Shores J, Reeves M. Tikhoff-Linberg procedure and chest wall resection for recurrent sarcoma of the shoulder girdle involving the chest wall. J Surg Oncol 2005;89:91–94.

    PubMed  Google Scholar 

  98. Hidalgo DA, Zenn MR, Marcove RC. Aesthetic reconstruction of Tikhoff-Linberg shoulder defects with a dual-pedicle TRAM free flap. Plast Reconstr Surg 1993;91:1340–1343.

    CAS  PubMed  Google Scholar 

  99. Yajima H, Tamai S, Ono H, Kizaki K, Yamauchi T. Free vascularized fibula grafts in surgery of the upper limb. J Reconstr Microsurg 1999;15:515–521.

    CAS  PubMed  Google Scholar 

  100. Jupiter JB, Kour AK. Reconstruction of the humerus by soft tissue distraction and vascularized fibula transfer. J Hand Surg [Am] 1991;16:940–943.

    Article  CAS  Google Scholar 

  101. Lukin AV, Kiss EE, Grishkin VA, Chernova VI. [Individual endoprosthesis in a malignant tumor of the humerus]. Vestn Khir Im I I Grek 1987;139:65–66.

    CAS  PubMed  Google Scholar 

  102. Grzesik M. [Endoprosthesis of the humerus in osteochondroma] Chir Narzadow Ruchu Ortop Pol 1966;31:763–767.

    CAS  PubMed  Google Scholar 

  103. D’Aniello C, Grimaldi L, Bosi B, Brandi C. Shoulder reconstruction by latissimus dorsi myocutaneous flap based on the serratus branch after advanced soft-tissue sarcoma excision. Plast Reconstr Surg 2000;105:2082–2085.

    PubMed  Google Scholar 

  104. Capanna R, Manfrini M, Briccoli A, Gherlinzoni F, Lauri G, Caldora P. Latissimus dorsi pedicled flap applications in shoulder and chest wall reconstructions after extracompartimental sarcoma resections. Tumori 1995;81:56–62.

    CAS  PubMed  Google Scholar 

  105. Ihara K, Shigetomi M, Muramatsu K, et al. Pedicle or free musculocutaneous flaps for shoulder defects after oncological resection. Ann Plast Surg 2003;50:361–366.

    PubMed  Google Scholar 

  106. Auba C, Yeste L, Herreros J, Hontanilla B. Upper-third arm and shoulder reconstruction with the island latissimus dorsi flap. J Shoulder Elbow Surg 2004;13:676–679.

    PubMed  Google Scholar 

  107. Shigehara T, Tsukagoshi T, Satoh K, Tatezaki S, Ishii, T. A reversed-flow latissimus dorsi musculocutaneous flap based on the serratus branch in primary shoulder reconstruction. Plast Reconstr Surg 1997;99:566–569.

    CAS  PubMed  Google Scholar 

  108. Sperling JW, Pritchard DJ, Morrey BF. Total elbow arthroplasty after resection of tumors at the elbow. Clin Orthop Relat Res 1999;367:256–261.

    PubMed  Google Scholar 

  109. Weber KL, Lin PP, Yasko AW. Complex segmental elbow reconstruction after tumor resection. Clin Orthop Relat Res 2003;415:31–44.

    PubMed  Google Scholar 

  110. Ceruso M, Angeloni R, Innocenti M, Lauri G, Capanna R, Bufalini C. [Reconstruction with free vascularized or island flaps of soft tissue loss in the upper limb after tumor resection. 16 cases]. Ann Chir Main Memb Super 1995;14:21–27.

    CAS  PubMed  Google Scholar 

  111. Innocenti M, Ceruso M, Angeloni R, et al. Reinnervated free gracilis muscle transplantation in the treatment of Volkmann’s syndrome of the forearm. Chir Organi Mov 1996;81:287–293.

    CAS  PubMed  Google Scholar 

  112. Yu GR, Yuan F, Chang SM, Lineaweaver WC, Zhang F. Microsurgical fibular graft for full-length radius reconstruction after giant-cell tumor resection: a case report. Microsurgery 2005;25:121–125.

    PubMed  Google Scholar 

  113. Fotopoulos P, Holmer P, Leicht P, Elberg JJ. Dorsal hand coverage with free serratus fascia flap. J Reconstr Microsurg 2003;19:555–559.

    PubMed  Google Scholar 

  114. Buehler MJ, Pacelli L, Wilson KM. Serratus fascia “sandwich” free-tissue transfer for complex dorsal hand and wrist avulsion injuries. J Reconstr Microsurg 1990;15:315–320.

    Google Scholar 

  115. Javaid M, Cormack GC. Anterolateral thigh free flap for complex soft tissue hand reconstructions. J Hand Surg [Br] 2003;28:21–27.

    CAS  Google Scholar 

  116. Muneuchi G, Suzuki S, Ito O, Kawazoe T. Free anterolateral thigh fasciocutaneous flap with a fat/fascia extension for reconstruction of tendon gliding surface in severe bursitis of the dorsal hand. Ann Plast Surg 2002;49:312–316.

    PubMed  Google Scholar 

  117. Eckardt JJ, Kabo JM, Kelley CM, et al. Expandable endoprosthesis reconstruction in skeletally immature patients with tumors. Clin Orthop Relat Res 2000;373:51–61.

    PubMed  Google Scholar 

  118. Innocenti M, Delcroix L, Manfrini M, Ceruso M, Capanna R. Vascularized proximal fibular epiphyseal transfer for distal radial reconstruction. J Bone Joint Surg Am 2005;87(Suppl l):237–246.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Baumeister, S., Levinson, H., Zenn, M., Levin, L.S. (2008). Extremity Reconstruction. In: Butler, C.E., Fine, N.A. (eds) Principles of Cancer Reconstructive Surgery. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-49504-0_11

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-49504-0_11

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-49502-6

  • Online ISBN: 978-0-387-49504-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics