Use of fillet flap in a case of soft-tissue sarcoma of the hand

Abstract

Soft-tissue sarcoma of the hand is a rare entity. Hand sarcomas are more challenging to manage than those in other sites, due to a variety of factors including highly specialized, intricate anatomy, and absence of redundant soft-tissue. Hand-sparing surgery is now the most common option for sarcomas of the hand. We present our experience of hand sparring surgery in a patient with sarcoma of a thumb. We present a rare case of clear cell sarcoma of the thenar region of the right hand, managed by hand preserving wide excision of the primary tumor and amputation of the thumb at the metacarpal level. The wide defect created after excision of the tumor was effectively covered by a fillet flap. Limb sparing, function preserving surgeries are the standard of care wherever possible. An effective technique, the fillet flap, which was pragmatic in providing a working hand for our patient can be valuable in a select group of patients in a low resource setting.