RESUMO
BACKGROUND: Limb-salvage surgery has become the backbone treatment for musculoskeletal tumors in the last decades. However, limb-salvage with safe margins for tumors of the foot and ankle is challenging, due to the complex anatomy of this region. This study aimed to evaluate functional and oncological outcomes, complications, and local recurrence of limb-salvage procedures for tumors of the foot and ankle. METHODS: This study was a retrospective review of 18 patients with primary tumors of the foot and ankle who underwent limb-salvage surgery between 1996 and 2015, with a minimum follow-up of 2 years. Clinical presentations, radiological and histopathological investigations, surgical procedures, functional and oncological outcomes, complications and local recurrences were analyzed. The Musculoskeletal Tumor Society (MSTS) scoring system was utilized for evaluation of the functional outcome. RESULTS: With a mean follow-up period of 44.2 months, 7 males and 11 females with a mean age of 29.2 years were included. Nine patients were presented as recurrent cases. The most common location was forefoot in 7 patients. Synovial sarcoma was the histopathologic diagnosis in 7 patients. The final surgical margins were wide in 15 patients, wide-contaminated in one patient, and marginal in two patients. After resection, soft tissue reconstruction and wound coverage were done by soft tissue flaps in 4 patients. The mean MSTS score was 27.5. Four patients developed local recurrence, all of them were recurrent cases. CONCLUSION: Limb-salvage surgery for foot and ankle tumors is an effective treatment option with good functional outcome. LEVEL OF EVIDENCE: Level IV, retrospective case series.
Assuntos
Tornozelo/cirurgia , Neoplasias Ósseas/cirurgia , Pé/cirurgia , Salvamento de Membro , Neoplasias de Tecidos Moles/cirurgia , Adolescente , Adulto , Amputação Cirúrgica/estatística & dados numéricos , Neoplasias Ósseas/mortalidade , Criança , Feminino , Seguimentos , Tumores de Células Gigantes/mortalidade , Tumores de Células Gigantes/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Recidiva Local de Neoplasia , Estudos Retrospectivos , Sarcoma/mortalidade , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/mortalidade , Retalhos Cirúrgicos , Adulto JovemRESUMO
A 46 year-old male presented suffering from refractory erectile dysfunction. The patient had a past history of pelvic chondro-sarcoma. This case was a challenge for us; the surgery performed for excision of the sarcoma has resulted in the elimination of both pubic ramia together with excision of part of both corpora and left hemiscrotum. The procedure included a sling application on one side with a mesh sock wrapped around the rear part of the extendor cylinder. Another sling was applied on the contra lateral side without a mesh sock.
