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Wide en bloc extra-articular excision of the elbow for sarcoma with complex reconstruction

¹ Harvard Medical School, Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
² Department of Surgery, Section of Orthopaedic Surgery Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.

Correspondence should be sent to Dr E. A. Athanasian; e-mail: athanasiane{at}hss.edu

We describe a consecutive series of five patients with bone or soft-tissue sarcomas of the elbow and intra-articular extension treated by complex soft tissue, allograft bone and prosthetic joint replacement after wide extra-articular en bloc excision. All had a pedicled myocutaneous latissimus dorsi rotation flap for soft-tissue cover and reconstruction of the triceps. Wide negative surgical margins were obtained in all five patients. No local wound complications or infections were seen. There were no local recurrences at a mean follow-up of 60 months (20 to 105). The functional results were excellent in four patients and good in one. Longer term follow-up is necessary to confirm the durability of the elbow reconstruction.