The use of fillet limb to reconstruct huge defect post trunk tumor excision

Abstract

Post girdle excision (forequarter amputation and hemi‐pelvectomy) for bone or soft tissue tumours result in extensive defects exposing bone and major neurovascular structures. Large flaps are necessary to reconstruct the defect and protect the underlying structures. Total thigh flap was first described in 1956 by Georgiade et al. for the treatment of large trochanteric ulcers with osteomyelitis of femur. Free fillet flaps from the amputated limb provides a large amount of soft tissue coverage without additional donor site morbidity and hence it is ideal in major reconstruction for these trunk defect. We had five patients with major excision of girdle tumour with two forequarter amputation, three hemipelvectomy (two osteosarcoma, three soft tissue sarcoma). Four fillet limbs were used (two upper limbs, two lower limbs, one multiple local transposition flaps). The clinical course, morbidity and mortality were discussed in this paper.