Functional outcome following upper limb soft tissue sarcoma resection with flap reconstruction

Summary Background Upper limb preservation after soft tissue sarcoma resection often requires flap reconstruction. The aim of this study was to compare pre- and post-operative upper limb function following shoulder, elbow or wrist/hand sarcoma resection and soft tissue reconstruction with a pedicled or free flap. Patients Between 1989 and 2008, 113 patients underwent resection of an upper limb soft tissue sarcoma and required flap reconstruction. Perioperative morbidity, mortality and flap loss were studied. Functional outcome was assessed pre and postoperatively using the Toronto Extremity Salvage Score (TESS), a measure of disability, and the Musculoskeletal Tumour Society Rating Scale (MSTS), a measure of impairment. Statistical analyses were performed to evaluate the relationship between flap type and functional outcome scores. Results Patients underwent soft tissue sarcoma excision in the shoulder ( n = 64), elbow ( n = 27) or wrist/hand ( n = 22) region with soft tissue reconstruction using either a pedicled ( n = 76) or free flap ( n = 37). Comparison of the post-operative MSTS ( n = 88) and TESS ( n = 84) revealed no significant differences between the free and pedicled flap groups. A significant pre- to post-operative difference was identified in MSTS 87 scores for patients in both the pedicled ( p