Functional Outcome of Upper Limb Reconstruction After Resection of Soft Tissue Sarcoma

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Author(s): Dr. Shah Zaib 1 , Dr. Rashmeen Khan Afridi2, Dr. Muhammad Ibrahim Khan3, Adeela Hussain Khan4, Dr. Farwa Shabbir5, Dr. Maimoona Goher6

Received: 29/01/2024 | Revised: 15/02/2024 | Published: 24/06/2024 | Pages: 10-15 | DOI: https://doi.org/10.5455/pjps.1706000831


Background: About 20% all soft tissue sarcoma involve the upper limb. Extensive surgical resections often
require reconstruction. The aim of reconstruction is an aesthetic and functional upper limb.
Objective: To determine the functional outcome of upper limb reconstruction after resection of soft tissue
sarcoma. This is a retrospective Cohort Study was done at Plastic and Reconstructive Surgery Shifa
International Hospital Islamabad Pakistan, from January 2013 to December 2022.
Methodology: Patient of either gender, between the age of 18 to 70 years, requiring upper limb reconstruction
after resection of soft tissue sarcoma were included in this study. TheWHOSample Size calculator calculated
the sample size 50%. Patients were clinically evaluated up to a six-month follow-up period using the
Musculoskeletal Tumor Society (MSTS) Score to evaluate functional outcomes. Functional outcomes were
labelled as excellent (>25 score), Good (20-25 Score), Satisfactory (10-19 Score) and Poor (< 10 score).
Results:TheMeanBaselineMSTS Scorewas 7.78+2.105while the six-monthMean follow-upMSTS Score
was 23.53+3.829. There was a statistically significant difference between the MSTS Scores pre and postoperatively
with a p-value < 0.001. Free flaps had 51.4% of Excellent functional outcomes while the Pedicled
flaps had 30.0% of Excellent functional outcomes. Fifty-one (92.7%) patients had no complications while
only 01 (1.8%) patient had partial flap loss and 03 (5.5%) patients had complications of wound infection and
delayed wound healing.
Conclusion: Excellent functional outcome was achieved in the appropriate immediate reconstruction of the
soft tissue defect following sarcoma resection in the upper limb.
Keywords | Functional Outcome, hand, limb-sparing surgery, Upper Limb Reconstruction, Resection, Soft Tissue Sarcoma.