American Association of Plastic Surgeons

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Reconstruction Distal To Ankle after Soft Tissue Sarcoma Resection
Luis Camacho, MD, Rami Elmorsi, MD, David Krijgh, MD, Gordon Tilney, PA-C, Heather Lyu, MD, Raymond Traweek, MD, Russell Witt, MD, Margaret Roubaud, MD, Arlene Correa, PhD, Christina Roland, MD, Rene Largo, MD, Alexander Mericli, MD
MD Anderson, Houston, TX, USA

PURPOSE: Sarcoma reconstructions distal to the ankle present unique challenges due to the foot's intricate anatomy and weight-bearing demands. This study assesses the safety and efficacy of foot and ankle oncologic reconstruction in a specialized oncologic center.
METHODS: A retrospective review of patients undergoing sarcoma reconstructions distal to the ankle from January 2016- December 2021 at MD Anderson was conducted. Data included demographics, tumor characteristics, surgical details, and postoperative outcomes. Statistical analysis involved Pearson Chi Square tests.
RESULTS: Of the 302 patients, 16 underwent reconstructions distal to the ankle. Average ages were 57.1516.6 overall and 4816.67 for the distal to ankle group. Myxofibrosarcoma was the most common pathology. Reconstructions: free flap (62.5%), pedicled flap (6.25%), complex closure (12.5%), and skin grafts. The distal to ankle group had no partial flap loss, one total flap loss (6.25%), 5 with any complications (31.3% vs. 38.1% overall) and 3 with major complications (18.8% vs. 15.6% overall). Pearson Chi-Square found no significant associations for complications.
CONCLUSION: While no significant associations were found for postoperative complications in our study, understanding potential preoperative and tumor-specific predictors remains crucial for surgical planning and postoperative management. This knowledge assists surgeons in optimizing strategies for improved outcomes in the complex anatomical region of the foot.


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