Free Functional Latissimus Dorsi Reconstruction of the Quadriceps and Hamstrings following Oncologic Resection of Soft Tissue Sarcomas of the Thigh

Figure 1

Axial MRI with contrast (a) showing a deep soft tissue mass which was inadvertently excised. The pathology was consistent with sarcoma, and on postexcision MRI (b), there was evidence of the surgical incision (arrow) which involved the sartorius, rectus femoris, and vastus medialis and intermedius. During the resection of these muscle groups, care is taken to identify the nerve fibers entering the muscle bellies which are tagged (ties) for repair (c). The free functional latissimus with a skin paddle was inset with care to be sure the resting tension was correct (d). Following surgery, the patient had active knee extension (e) and ambulated without gait aids.

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