Segmental Resection and Replantation Have a Role for Selected Advanced Sarcomas in the Upper Limb

  • Soo Bong Hahn
  • Yun Rak ChoiEmail author
  • Ho Jung Kang
  • Kyoo Ho Shin
Original Article


Although limb salvage surgery for primary sarcoma of the upper limb is a standard procedure, it often is technically challenging. We asked whether segmental resection and replantation would provide (1) local control and long-term survival and (2) useful limb function in patients who had advanced primary malignant and aggressive tumors of the upper limbs. We retrospectively reviewed six patients treated with this procedure when a wide resection around the tumor could not be achieved with other limb-salvage procedures. Diagnoses included osteosarcoma (two), Ewing’s sarcoma (one), leiomyosarcoma (one), and giant cell tumor (two). Four patients had displaced pathologic fractures. Minimum followup was 40 months (mean, 164 months; range, 40–214 months). All but one patient remained disease-free; the patient with Ewing’s sarcoma died from the disease 40 months after surgery. The average functional score at last followup was 20 points. The mean grasping and pinching power of the operative hand were 66% and 72% of the contralateral side, respectively. Two patients had complications: one had wound dehiscence that subsequently healed and one had radial nerve palsy that recovered spontaneously by 3 months. Segmental resection and replantation may have a role in selected cases for treatment of advanced primary sarcoma or aggressive giant cell tumor of the upper limb as partial limb salvage.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.


Ulnar Nerve Giant Cell Tumor Coracoid Process Radial Nerve Palsy Primary Sarcoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Dong Su Jang and Dane K. Grace for their efforts in preparing the manuscript for publication.


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Copyright information

© The Association of Bone and Joint Surgeons® 2009

Authors and Affiliations

  • Soo Bong Hahn
    • 1
  • Yun Rak Choi
    • 1
    Email author
  • Ho Jung Kang
    • 1
  • Kyoo Ho Shin
    • 1
  1. 1.Department of Orthopaedic SurgeryYonsei University College of MedicineSeoulSouth Korea

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