Comparison of flap reconstruction for soft tissue sarcomas of the foot and ankle

Katherine E. Mallett, Matthew T. Houdek, Rachel L. Honig, Karim Bakri, Peter S. Rose, Steven L. Moran

Research output: Contribution to journalArticlepeer-review


Background: Foot and ankle soft tissue sarcomas (STS) are challenging for reconstruction due to limited surrounding soft tissue and weight-bearing requirements. Currently, there is a paucity of data examining the outcome of flap reconstruction following resection of a foot and ankle sarcoma. Methods: We reviewed 44 (31 female, 13 male) patients with STS arising from the ankle or foot which required coverage in the form of a free (n = 21), pedicled (n = 13), or rotational perforator flap (n = 10). The mean tumor size was 6 ± 5 cm, with 39 (89%) patients receiving radiotherapy. The mean follow-up was 10 ± 7 years. Results: There were no cases of amputation due to flap failure, with a 10-year limb salvage rate of 84%. Complications occurred in 19 (43%) patients, most commonly wound infections. There was no difference in the incidence of complications between patients undergoing a free flap and pedicled or perforator flap (odds ratio = 0.97, p = 1.0); with no difference in the mean Musculoskeletal Tumor Society (MSTS) score between patients with a free flap versus a pedicled/perforator flap (84% vs. 76%, p = 0.11). Conclusion: Flap reconstruction is an essential part of limb salvage for foot and ankle STS. At final follow-up nearly all the patients are ambulatory with an acceptable MSTS score.

Original languageEnglish (US)
Pages (from-to)995-1001
Number of pages7
JournalJournal of Surgical Oncology
Issue number7
StatePublished - Dec 1 2021


  • foot and ankle
  • free flap
  • limb salvage
  • sarcoma

ASJC Scopus subject areas

  • Surgery
  • Oncology


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