ABSTRACT
Background: Extremity sarcomas are challenging to manage. Total eradication of tumour has to
be balanced with restoration of limb function to prevent mortality and morbidity.
Disease-free survival with maximum limb function is the ultimate goal in these patients.
Materials and Methods: We present a series of ten cases of extremity malignancies, where limb salvage was
attempted with microvascular free fibula for limb reconstruction from the period of
2008 to 2015. Results: Of the ten cases in the study, there were two females and eight males. There were
nine patients with lower limb malignancies and one patient with upper limb malignancy.
There were four patients with Ewing’s sarcoma of femur, five patients with osteosarcoma
of femur and one patient with chondrosarcoma of the humerus. The follow-up period
ranged from 1.2 to 6.2 years with mean follow-up of 3.1 years. There were two deaths
during follow-up, both were due to distant metastasis. The assessment of the function
was done on the basis of Musculoskeletal Tumour Society functional score. Maximum
score was 30 and minimum score was 24, the average score being 26. Of the eight surviving
patients, three patients had full weightbearing, four patients had partial weightbearing
at end of 2 years and one patient of upper limb reconstruction had complete upper
limb function. None of the patients had to undergo limb amputation. Conclusion: Limb salvage with vascularised fibula graft offers good functional outcome along
with good disease-free survival rates.
KEY WORDS
Bone sarcoma - limb salvage - vascularised fibula flap
