Redit, Ragnild Anak (2022) Functional outcomes of free muscle transfer following oncological resection in extremity sarcoma: A comparison study between neurovascularised and non neurovascularised flaps. Masters thesis, Universiti Sains Malaysia.
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Abstract
Introduction Wide margin surgery combined with adjuvant radiotherapy has become the mainstay of treatment in extremity sarcomas, even in large sarcomas. Free muscle transfers are usually indicated for reconstruction of major defect following massive oncological resection. Apart from soft tissue coverage, functional restoration is possible by motorising the recipient motor nerve of the muscle flap. Methods This was a retrospective cohort study to determine and compare the functional outcomes between neurovascularised and non neurovascularised flaps, as well as the donor site morbidity who had undergone free muscle transfer following oncological resection surgery for extremity sarcoma. Functional outcomes of the surgery were then determined based on clinical examination, including muscle power and range of motion (ROM) of the affected extremity; and questionnaires, including the Musculoskeletal Tumour Society (MSTS) score, Lower Extremity Functional Scale (LEFS) and QuickDASH (Disabilities of Arm, Shoulder and Hand) questionnaire. Results A total of 16 patients (11 males and 5 females) with a median age of the patients was 33 years old were recruited for this study. All the patients had lesions in the lower extremity and were reconstructed with a free latissimus dorsi muscle flap. Overall functional outcome ranged from excellent to fair (median MSTS score of 26 and median LEFS score of 57), with muscle strength of replace muscle of at least M3 in all but 2 patients. There were no significant association in the functional outcomes between both neurovascularised and non neurovascularised groups. There was only 1 patient with minor donor site complication (seroma) and functional outcome of the donor site was acceptable. Conclusion The functional outcomes of limb salvage surgery are shown to be good to excellent, however there is no significant difference between the type of free muscle transfer in the reconstruction of the resected muscle compartment in our study. This result implied that functional neurovascularised muscle flap in major resection also achieved good functional outcome. Donor site morbidity for latissimus dorsi muscle harvest is acceptable, but not negligible with limited to no functional limitations in activities of daily living.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | neurovascularised |
| Subjects: | R Medicine R Medicine > RD Surgery |
| Divisions: | Kampus Kesihatan (Health Campus) > Pusat Pengajian Sains Perubatan (School of Medical Sciences) > Thesis |
| Depositing User: | MUHAMMAD AKIF AIMAN AB SHUKOR |
| Date Deposited: | 30 Jun 2026 03:47 |
| Last Modified: | 30 Aug 2026 08:07 |
| URI: | http://eprints.usm.my/id/eprint/64519 |
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