Surgical treatment of malignant tumors of the foot and ankle.

BACKGROUND

The current study highlights the clinical features of tumors of the foot and ankle, and presents the clinical outcomes of treatment for 16 patients who were treated at the authors' institution, between 1989 and 1998.

METHODS

Four tumors occurred in the ankle, three were in the hindfoot, three were in the midfoot, three were in the forefoot, and three were on the plantar surface of the foot. The median duration of symptoms before presentation was 12 months (range, 1-50 months). Fourteen patients were managed by limb-salvage procedures. Three patients were managed by ablative surgery, due to skin, neurovascular, and/or severe bone invasion. In the 9 patients who had wide local resections, local island flaps, split-thickness skin grafts, free vascularized latissimus dorsi flaps, and a free vascularized iliac crest flap were utilized to achieve wound closure.

RESULTS

The patients were followed up for a mean of 74.2 months (range, 48-121 months). The overall survival of the whole group is 71 +/- 3.7 months. Currently, 12 patients are being followed up with no evidence of disease. Of the 14 patients who were managed by limb-salvage procedures, 6 have normal functional status.

CONCLUSION

Wide resection of malignant tumors of the foot and ankle is considered technically difficult because of technical problems of soft-tissue coverage. However, utilization of local and free flaps provides sufficient closure following wide tumor resection of the foot and ankle, thus yielding satisfactory lower extremity function and local tumor control.