Functional reconstruction of the extensor mechanism following massive tumor resections from the anterior compartment of the thigh.

Abstract

The authors describe the surgical technique and functional results of extensor mechanism reconstruction after major resections of soft-tissue tumors from the anterior compartment of the thigh. Between 1983 and 2003, 78 patients with soft-tissue sarcomas of the anterior compartment of the thigh were operated on at the authors' institution. Sixteen patients with extensive resections of the quadriceps muscle and one patient with a complete resection of the femoral nerve underwent functional extensor mechanism reconstruction. Depending on the type of resection, one or more of the following muscles were used for reconstruction: the sartorius, biceps femoris, semitendinosus muscles. After two patients with a follow-up of less than 12 months were excluded, 15 patients were evaluated. The authors performed a retrospective analysis of these patients' medical records, with an emphasis on functional outcome. According to the Musculoskeletal Tumor Society score, functional results were estimated to be good to excellent in 13 patients and fair in two. Most patients had a satisfactory active range of motion, and muscle strength and functional results correlated with the extent of resection. The authors recommend functional muscle transfer reconstruction after extensive resection of the quadriceps muscle or resection of the femoral nerve with one or more of the following muscles: the sartorius, the biceps femoris, and the semitendinosus muscles.