Biological extremity reconstruction after sarcoma resection: past, present, and future

Abstract

In sarcoma surgery besides a wide local resection, limb salvage became more and more important. Reconstruction of bone and soft tissue defects after sarcoma resection poses a major challenge for surgeons. Nowadays a broad range of reconstructive methods exist to deal with bony defects. Among these are prostheses, bone autografts, or bone allografts. Furthermore a variety of plastic reconstructive techniques exist that allow soft tissue reconstruction or coverage after sarcoma resection. Here we discuss the historical highlights, the present role, and possible future options for biological reconstruction.

Figure 1

Axolotl or Mexican salamander (Ambystoma mexicanum), one of the few species that maintains the ability to regenerate its tail or limbs throughout its life. Karol Głąb/Wikipedia Creative Commons.

Figure 2

Chondrosarcoma G2 at the proximal humerus shown in the X-ray (a) and MRI ((b), (c)). Nine-month postoperative X-rays showing the reconstruction after wide resection with an autologous free vascularized fibula graft ((d), (e)).