scholarly journals The Bateman-Type Soft Tissue Reconstruction around Proximal or Total Humeral Megaprostheses in Patients with Primary Malignant Bone Tumors—Functional Outcome and Endoprosthetic Complications

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 3971
Author(s):  
Helmut Ahrens ◽  
Christoph Theil ◽  
Georg Gosheger ◽  
Robert Rödl ◽  
Niklas Deventer ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Functional Outcome ◽  
Bone Tumor ◽  
Revision Surgery ◽  
Soft Tissue Reconstruction ◽  
Malignant Bone Tumor ◽  
Musculoskeletal Tumor Society ◽  
Primary Malignant Bone Tumor ◽  
Toronto Extremity Salvage Score ◽  
Tissue Reconstruction

We aimed to evaluate the functional outcome and endoprosthetic complications following the Bateman-type soft tissue reconstruction around proximal or total humeral replacements in patients undergoing resection of a primary malignant bone tumor. Between September 2001 and December 2018, a total of 102 patients underwent resection of a primary malignant bone tumor and subsequent reconstruction with a modular humeral megaprosthesis in our department. Fifteen (15%) of these patients underwent a Bateman-type soft tissue reconstruction and were included in this retrospective study. The median Musculoskeletal Tumor Society (MSTS) score was 21, the median Toronto Extremity Salvage Score (TESS) was 70, and the median American Shoulder and Elbow Surgeons (ASES) score was 72. Fifty-three percent (8/15) of all patients required a revision surgery after a median time of 6 months. There were 2 soft tissue failures, 3 infections and 3 tumor recurrences. The revision-free implant survivorship amounted to 53% (95% confidence interval (CI) 28–81) after 1 year and 47% (95% CI 22–73) at last follow-up. The Bateman-type reconstruction is a feasible option for soft tissue reconstruction but functional outcome is overall limited and the risk for revision surgery within the first postoperative year is high.

scholarly journals Functional Outcome After Lower Extremity Soft Tissue Sarcoma Treatment: A Pilot Study Based on Translated and Culturally Adapted Measures

2018 ◽  
Vol 108 (2) ◽  
pp. 164-171
Author(s):  
G. Kask ◽  
I. Barner-Rasmussen ◽  
J. Repo ◽  
C. Blomqvist ◽  
E. Tukiainen
Keyword(s):  
Pilot Study ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Lower Extremity ◽  
Functional Outcome ◽  
Soft Tissue Sarcomas ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Toronto Extremity Salvage Score ◽  
Extremity Salvage

Background and Aims: The present standard of care in treating lower extremity soft tissue sarcomas is function-sparing, limb-preserving resection and reconstruction with or without oncological therapy. The aim of this pilot study was to test the suitability and adequacy of the Finnish translations of two functional outcome questionnaires (Toronto Extremity Salvage Score and Musculoskeletal Tumor Society score) and to perform a preliminary investigation of functional outcomes of Finnish lower-limb soft tissue sarcoma patients after operative treatment. Materials and Methods: Between June 2015 and December 2015, consecutive surgically treated outpatients were asked to participate in the study. Demographic, clinical, surgical, and oncological outcome data were collected. Two functional outcome questionnaires were used (Toronto Extremity Salvage Score and Musculoskeletal Tumor Society scores). A comparative analysis is presented. Results: A total of 19 lower-limb soft tissue sarcoma patients with a mean follow-up time of 2 years and 10 months were included. All (n = 19) invited patients participated in the study. Mean age was 62.3 years. In total, 13 had high-grade sarcomas. Eight wounds were closed directly, four used skin grafts, and five required flap reconstructions. One patient required a tumor prosthesis, and one required a rotationplasty. A total of 14 patients received oncological therapy. No problems or difficulties were reported in using and completing the Finnish versions of the Toronto Extremity Salvage Score or Musculoskeletal Tumor Society questionnaires. The overall Toronto Extremity Salvage Score and Musculoskeletal Tumor Society scores were 88 and 76, respectively. Conclusion: This pilot study suggests that the Finnish versions of the Toronto Extremity Salvage Score and Musculoskeletal Tumor Society questionnaires are suitable for measuring functional outcome after lower extremity soft tissue sarcomas treatment. Functional outcomes vary from moderate to excellent.

scholarly journals Reconstructions of the Shoulder following Tumour Resection

2007 ◽  
Vol 15 (2) ◽  
pp. 201-206 ◽  
Author(s):  
Y Kitagawa ◽  
DM Thai ◽  
PFM Choong
Keyword(s):  
Soft Tissue ◽  
Postoperative Complications ◽  
Revision Surgery ◽  
Tumour Resection ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Toronto Extremity Salvage Score ◽  
Functional Assessments ◽  
Extremity Salvage ◽  
Effective Function

Purpose. To review and compare the postoperative outcomes of 3 types of shoulder reconstructions: prosthetic arthroplasty, clavicula pro humero reconstruction, and allograft arthrodesis. Methods. Records of 25 shoulder reconstructions following tumour resection were retrospectively reviewed. Perioperative data, oncological prognoses, postoperative complications, and functions were assessed. Results. We performed 10 prosthetic arthroplasties, 7 clavicula pro humero procedures, 4 allograft arthrodeses, and 4 soft tissue reconstructions. Eight patients died of their diseases. Three developed complications and underwent revision surgery. 19 patients achieved stable shoulders. Ten patients attended for functional assessments. Respective mean scores using the Musculoskeletal Tumor Society-International Symposium on Limb Salvage and the Toronto Extremity Salvage Score were: 77% and 82% for prosthetic arthroplasties, 67% and 62% for clavicula pro humero procedures, 83% and 70% for allograft arthrodeses, and 93% and 98% for soft tissue reconstructions. Conclusion. A stable construct is the treatment goal for shoulder reconstructions, as it enables effective function of the arm and hand.

Functional Outcome after Soft-Tissue Reconstruction for Limb Salvage after Sarcoma Surgery

1998 ◽  
Vol 102 (5) ◽  
pp. 1576-1583 ◽  
Author(s):  
Joseph M. Serletti ◽  
Alexis J. Carras ◽  
Regis J. O'Keefe ◽  
Randy N. Rosier
Keyword(s):  
Soft Tissue ◽  
Functional Outcome ◽  
Limb Salvage ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction

scholarly journals Hyperspectral Imaging (HSI) as a new diagnostic tool in free flap monitoring for soft tissue reconstruction: a proof of concept study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lukas H. Kohler ◽  
Hannes Köhler ◽  
Simon Kohler ◽  
Stefan Langer ◽  
Rima Nuwayhid ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Hyperspectral Imaging ◽  
Free Flap ◽  
Revision Surgery ◽  
Soft Tissue Reconstruction ◽  
Valuable Data ◽  
Free Flap Surgery ◽  
Free Flap Monitoring ◽  
Flap Monitoring ◽  
Tissue Reconstruction

Abstract Objectives Free flap surgery is an essential procedure in soft tissue reconstruction. Complications due to vascular compromise often require revision surgery or flap removal. We present hyperspectral imaging (HSI) as a new tool in flap monitoring to improve sensitivity compared to established monitoring tools. Methods We performed a prospective observational cohort study including 22 patients. Flap perfusion was assessed by standard clinical parameters, Doppler ultrasound, and HSI on t0 (0 h), t1 (16–28 h postoperatively), and t2 (39–77 h postoperatively). HSI records light spectra from 500 to 1000 nm and provides information on tissue morphology, composition, and physiology. These parameters contain tissue oxygenation (StO2), near-infrared perfusion- (NIR PI), tissue hemoglobin- (THI), and tissue water index (TWI). Results Total flap loss was seen in n = 4 and partial loss in n = 2 cases. Every patient with StO2 or NIR PI below 40 at t1 had to be revised. No single patient with StO2 or NIR PI above 40 at t1 had to be revised. Significant differences between feasable (StO2 = 49; NIR PI = 45; THI = 16; TWI = 56) and flaps with revision surgery [StO2 = 28 (p < 0.001); NIR PI = 26 (p = 0.002); THI = 56 (p = 0.002); TWI = 47 (p = 0.045)] were present in all HSI parameters at t1 and even more significant at t2 (p < 0.0001). Conclusion HSI provides valuable data in free flap monitoring. The technique seems to be superior to the gold standard of flap monitoring. StO2 and NIR PI deliver the most valuable data and 40 could be used as a future threshold in surgical decision making. Clinical Trial Register This study is registered at the German Clinical Trials Register (DRKS) under the registration number DRKS00020926.

Autologous Fat Transfer and Cell-Based Strategies for Soft Tissue Reconstruction

2014 ◽  
Vol 3 (1) ◽  
pp. 62-69
Author(s):  
Kshemendra Senarath-Yapa ◽  
Rebecca Garza ◽  
Adrian McArdle ◽  
Graham Walmsley ◽  
Michael Hu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Reconstruction ◽  
Fat Transfer ◽  
Autologous Fat ◽  
Autologous Fat Transfer ◽  
Tissue Reconstruction

scholarly journals One-Stage Soft Tissue Reconstruction Following Sarcoma Excision: A Personalized Multidisciplinary Approach Called “Orthoplasty”

2020 ◽  
Vol 10 (4) ◽  
pp. 278
Author(s):  
Andrea Angelini ◽  
Cesare Tiengo ◽  
Regina Sonda ◽  
Antonio Berizzi ◽  
Franco Bassetto ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Lower Limbs ◽  
Surgical Approaches ◽  
Soft Tissue Reconstruction ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
One Stage ◽  
Unplanned Excision ◽  
Increased Risk ◽  
Toronto Extremity Salvage Score

Background and Objectives. Wide surgical resection is a relevant factor for local control in sarcomas. Plastic surgery is mandatory in demanding reconstructions. We analyzed patients treated by a multidisciplinary team to evaluate indications and surgical approaches, complications and therapeutic/functional outcomes. Methods. We analyzed 161 patients (86 males (53%), mean age 56 years) from 2006 to 2017. Patients were treated for their primary tumor (120, 75.5%) or after unplanned excision/recurrence (41, 25.5%). Sites included lower limbs (36.6%), upper limbs (19.2%), head/neck (21.1%), trunk (14.9%) and pelvis (8.1%). Orthoplasty has been considered for flaps (54), skin grafts (42), wide excisions (40) and other procedures (25). Results. At a mean follow-up of 5.3 years (range 2–10.5), patients continuously showed no evidence of disease (NED) in 130 cases (80.7%), were alive with disease (AWD) in 10 cases (6.2%) and were dead with disease (DWD) in 21 cases (13.0%). Overall, 62 patients (38.5%) developed a complication (56 minor (90.3%) and 6 major (9.7%)). Flap loss occurred in 5/48 patients (10.4%). The mean Musculoskeletal Tumor Society (MSTS) and Toronto Extremity Salvage Score (TESS) was 74.8 ± 14 and 79.1 ± 13, respectively. Conclusions. Orthoplasty is a combined approach effective in management of sarcoma patients, maximizing adequate surgical resection, limb salvaging and functional recovery. One-stage reconstructions are technically feasible and are not associated with increased risk of complications.

scholarly journals Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhao Yang ◽  
Chao Xu ◽  
Yong-Gang Zhu ◽  
Jun Li ◽  
Zi-Xiang Wu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Infection Rate ◽  
Clinical Data ◽  
Open Fractures ◽  
Soft Tissue Reconstruction ◽  
Satisfactory Outcome ◽  
Tissue Damages ◽  
Tissue Reconstruction ◽  
Severe Soft Tissue

Abstract Objective This study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities. Methods The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. Results The mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. Conclusion The overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

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