Reconstruction of oncologic upper extremity defects with fibula free flaps has high union rates and excellent functional outcomes Journal Article
| Authors: | Shahzad, F.; Fazzalari, A.; Zoghbi, Y.; Coriddi, M. R.; Chapman, T. R.; Mehrara, B. J.; Disa, J. J.; Cordeiro, P. G.; Healey, J.; Athanasian, E. |
| Article Title: | Reconstruction of oncologic upper extremity defects with fibula free flaps has high union rates and excellent functional outcomes |
| Abstract: | Background: Limb salvage has better functional outcomes than amputation in the upper extremity. This can however be challenging after bony tumor resections. Methods: This is a retrospective case series of patients who underwent humerus, ulna, or radius reconstruction with a fibula free flap. Data were collected on demographics, oncologic history, surgical details, and complications. Functional outcome measures included the patient's ability to perform activities of daily living (ADL), presence of pain, and musculoskeletal tumor society (MSTS) score. Results: Over a 25-year period, 38 reconstructions were performed. The flap success rate was 97.5%. Bony union was obtained in 19 of 19 (100%) forearm reconstructions and in 15 of 19 (79%) humerus reconstructions (p = 0.10). All 19 forearm reconstruction patients and 18/19 humerus reconstruction patients were able to perform ADLs with no pain or only occasional pain. The MSTS scores were not significantly different between the humerus and forearm cohorts (27.1 vs. 27.3, p = 0.68). Functional outcomes were significantly better in limbs that achieved union (p < 0.001). Recipient and donor site complications occurred in 10 (26.3%) and 5 (13%) patients, respectively. Conclusions: Oncologic upper-extremity reconstruction with fibula free flaps has excellent functional outcomes. Bone union is a predictor of superior limb function. © 2023 Wiley Periodicals LLC. |
| Keywords: | treatment outcome; bone neoplasms; bone tumor; humerus; bone transplantation; retrospective studies; pain; retrospective study; daily life activity; free tissue graft; musculoskeletal disease; soft tissue tumor; activities of daily living; musculoskeletal diseases; radius; free flap; free tissue flaps; upper extremity; ulna; upper limb; fibula free flap; humans; human; neoplasms, connective and soft tissue; musculoskeletal tumor society score; oncologic upper extremity |
| Journal Title: | Journal of Surgical Oncology |
| Volume: | 128 |
| Issue: | 8 |
| ISSN: | 0022-4790 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2023-12-15 |
| Start Page: | 1416 |
| End Page: | 1427 |
| Language: | English |
| DOI: | 10.1002/jso.27418 |
| PUBMED: | 37563928 |
| PROVIDER: | scopus |
| PMCID: | PMC10840954 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Farooq Shahzad -- Source: Scopus |
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