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Forequarter Amputation and Reconstructive Options.
Ann Plast Surg. 2020 Jun; 84(6):651-656.AP

Abstract

OBJECTIVE

This study aimed to present the results of a series of forequarter amputations (FQAs) and to evaluate the reconstructive methods used.

SUMMARY BACKGROUND DATA

Although FQA has become a rare procedure in the era of limb-sparing treatment of extremity malignancies, it is a useful option when resection of a shoulder girdle or proximal upper extremity tumor cannot be performed so as to retain a functional limb.

METHODS

Thirty-four patients were treated with FQA in 1989 to 2017. Various reconstructive techniques were used, including free fillet flaps from the amputated extremity.

RESULTS

All patients presented with intractable symptoms such as severe pain, motor or sensory deficit, or limb edema. Seventeen patients were treated with palliative intent. Chest wall resection was performed in 9 patients. Free flap reconstruction was necessary for 15 patients, with 11 free flaps harvested from the amputated extremity. There was no operative mortality, and no free flaps were lost. In curatively treated patients, estimated 5-year disease-specific survival was 60%. Median survival in the palliatively treated group was 13 months (1-35 months).

CONCLUSIONS

Limb-sparing treatment is preferable for most shoulder girdle and proximal upper extremity tumors. Sometimes, FQA is the only option enabling curative treatment. In palliative indications, considerable disease-free intervals and relief from disabling symptoms can be achieved. The extensive tissue defects caused by extended FQA can be safely and reliably reconstructed by means of free flaps, preferably harvested from the amputated extremity.

Authors+Show Affiliations

From the Division of Plastic Surgery, HUS Helsinki University Hospital and University of Helsinki, Helsinki.From the Division of Plastic Surgery, HUS Helsinki University Hospital and University of Helsinki, Helsinki.From the Division of Plastic Surgery, HUS Helsinki University Hospital and University of Helsinki, Helsinki.Department of Plastic Surgery, Oulu University Hospital, Oulu, Finland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32149840

Citation

Tukiainen, Erkki, et al. "Forequarter Amputation and Reconstructive Options." Annals of Plastic Surgery, vol. 84, no. 6, 2020, pp. 651-656.
Tukiainen E, Barner-Rasmussen I, Popov P, et al. Forequarter Amputation and Reconstructive Options. Ann Plast Surg. 2020;84(6):651-656.
Tukiainen, E., Barner-Rasmussen, I., Popov, P., & Kaarela, O. (2020). Forequarter Amputation and Reconstructive Options. Annals of Plastic Surgery, 84(6), 651-656. https://doi.org/10.1097/SAP.0000000000002204
Tukiainen E, et al. Forequarter Amputation and Reconstructive Options. Ann Plast Surg. 2020;84(6):651-656. PubMed PMID: 32149840.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Forequarter Amputation and Reconstructive Options. AU - Tukiainen,Erkki, AU - Barner-Rasmussen,Ian, AU - Popov,Pentscho, AU - Kaarela,Outi, PY - 2020/3/10/pubmed PY - 2020/3/10/medline PY - 2020/3/10/entrez SP - 651 EP - 656 JF - Annals of plastic surgery JO - Ann Plast Surg VL - 84 IS - 6 N2 - OBJECTIVE: This study aimed to present the results of a series of forequarter amputations (FQAs) and to evaluate the reconstructive methods used. SUMMARY BACKGROUND DATA: Although FQA has become a rare procedure in the era of limb-sparing treatment of extremity malignancies, it is a useful option when resection of a shoulder girdle or proximal upper extremity tumor cannot be performed so as to retain a functional limb. METHODS: Thirty-four patients were treated with FQA in 1989 to 2017. Various reconstructive techniques were used, including free fillet flaps from the amputated extremity. RESULTS: All patients presented with intractable symptoms such as severe pain, motor or sensory deficit, or limb edema. Seventeen patients were treated with palliative intent. Chest wall resection was performed in 9 patients. Free flap reconstruction was necessary for 15 patients, with 11 free flaps harvested from the amputated extremity. There was no operative mortality, and no free flaps were lost. In curatively treated patients, estimated 5-year disease-specific survival was 60%. Median survival in the palliatively treated group was 13 months (1-35 months). CONCLUSIONS: Limb-sparing treatment is preferable for most shoulder girdle and proximal upper extremity tumors. Sometimes, FQA is the only option enabling curative treatment. In palliative indications, considerable disease-free intervals and relief from disabling symptoms can be achieved. The extensive tissue defects caused by extended FQA can be safely and reliably reconstructed by means of free flaps, preferably harvested from the amputated extremity. SN - 1536-3708 UR - https://www.unboundmedicine.com/medline/citation/32149840/Forequarter_Amputation_and_Reconstructive_Options L2 - https://doi.org/10.1097/SAP.0000000000002204 DB - PRIME DP - Unbound Medicine ER -
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