Soft tissue sarcomas are rare, reaching some 1.5% of all malignant tumors. While formerly the surgical management of sarcomas almost exclusively consisted of amputation, in the recent years limb saving surgery has become the first choice of therapy. Negative factors affecting the survival rate are: histologically high-grade tumor, size and localization of the tumor, vascular invasion, extensive tumor necrosis, certain subgroups, local recurrence and oncologically positive surgical margin at the resection. Many modern reconstruction possibilities are essential for the safe limb saving surgery with wide surgical margins, such as bone allograft implantation, tumor endoprostheses reconstruction, vascular grafting and plastic surgery. There should always be an attempt to perform limb saving surgery, however life quality, life expectancy and survival are more important considerations influencing essentially the surgical method of choice. In our follow-up study no significant difference in recurrence rate was found between the group of patients with sarcomas requiring a complex reconstruction procedure and the group of those treated by only resection methods (32% versus 47%).
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Lymphology
January 2025
Vascular Medicine Unit, Cholet Hospital, Cholet, France.
Access to trained lymphedema care providers remains limited making patient-driven management solutions essential. One such option, sequential intermittent pneumatic compression (IPC), has gained traction as a supportive tool for lymphedema management. While newer IPC devices and innovative applications are being introduced to the market, questions regarding the safety and efficacy of this technology persist.
View Article and Find Full Text PDFJ Orthop
July 2025
Head of School, Sepsis, and Limb Reconstruction, Nelson Mandela School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, 719 Umbilo Road, 4001, Durban, South Africa.
Background: Disease progression (DP) of osteosarcomas, albeit with aggressive treatments, hinders improving survival. The DP patterns are unique in low- and middle-income countries like South Africa. We determine the prognostic factors associated with disease progression (DP) of the appendicular skeleton's central high-grade conventional osteosarcoma (COS).
View Article and Find Full Text PDFJ Med Case Rep
January 2025
Bone and Joint Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Background: Management of the extensive soft tissue injuries remains a significant challenge in orthopedic and plastic reconstructive surgery. Since the thumb is responsible for 40% of the functions of the hand, saving and reconstructing a mangled thumb is essential for the patient's future.
Case Presentation: This case report describes the management of a severe occupational thumb injury in a 25-year-old white Persian male who sustained an occupational injury to his left thumb, resulting in extensive burn, crush injury to the distal and proximal phalanx, and severe soft tissue damage to the first metacarpal, thenar, and palmar areas.
Eur J Trauma Emerg Surg
January 2025
Department of Surgery, Division of Trauma Surgery, Charlotte-Maxeke Johannesburg Academic Hospital, University of Witwatersrand, Johannesburg, South Africa.
Purpose: To determine modifiable and non-modifiable factors contributing to limb loss in PAI the relevance and accuracy of published scoring systems for PAI within a South African State hospital.
Methodology: Retrospective review of patients (> 18 years) with PAI, presenting to CMJAH trauma unit from 1 January 2017 to 31 December 2022.
Results: Sixty-four patient records were analysed.
J Vasc Surg
January 2025
Nephrology Division, University of Washington, Seattle, WA; Providence Medical Research Center, Providence Inland Northwest Health, Spokane, WA.
Background: Chronic limb-threatening ischemia (CLTI) in patients with chronic kidney disease (CKD) has a high risk of poor outcomes. We aimed to compare the outcomes of lower extremity revascularization in patients with CLTI stratified by CKD severity in patients enrolled in the prospective, randomized Best Endovascular vs Best Surgical Therapy in Patients with CLTI (BEST-CLI) trial.
Methods: The BEST-CLI trial dataset was queried to categorize patients into three groups according to CKD stage.
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