Limb function after excision of a deltoid muscle sarcoma.
BACKGROUND
Limb function after excision of deltoid muscle sarcomas has not been thoroughly investigated, although a large defect of soft tissue often causes some degree of dysfunction after wide excision. We formulated a hypothesis that the limb functional results depend on the volume of the excised deltoid muscle and examined the clinical outcomes in patients with a sarcoma in the deltoid muscle treated by surgical resection.


METHODS
The clinical outcomes of 8 patients with a malignant soft tissue tumor in the deltoid muscle were retrospectively reviewed. The following items were evaluated: type of excision of the deltoid muscle, including total excision, subtotal excision, and partial excision; surgical margins; reconstruction procedure used; postoperative complications; local recurrence; metastasis; survival; and functional results (determined by the Musculoskeletal Tumor Society scoring system).


RESULTS
After surgical resection, reconstruction in 6 of 8 patients was performed by pedicled latissimus dorsi musculocutaneous or muscle flap or pedicled trapezius musculocutaneous flap. Two patients did not undergo reconstruction because skin closure was possible. The partial excision group had a Musculoskeletal Tumor Society score of 100.0%, and the subtotal excision case and the total excision group had scores of 76.6% and 82.2%, respectively. None of the patients has demonstrated any evidence of local recurrence.


CONCLUSIONS
We conclude that the functional results may depend on the volume of the excised deltoid muscle. Latissimus dorsi and trapezius musculocutaneous flaps were found to be useful for covering a defect of the deltoid muscle, although these flaps did not contribute to function of the shoulder.
Department of Orthopaedic Surgery, Iwate Prefectural Ninohe Hospital, Horino, Ninohe, 028-6193 Japan.
Yoshikuni
Y
Mimata
Jun
J
Nishida
Makoto
M
Gotoh
Toshiki
T
Akasaka
Tadashi
T
Shimamura
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057645:Deltoid Muscle / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*; D012782:Shoulder; D013524:Surgical Flaps; D016896:Treatment Outcome
Case Series; Level IV; Limb function; Treatment Study; deltoid muscle; malignant soft tissue tumor; musculocutaneous flap; reconstruction; wide excision