Excision of quadriceps muscle group.

Excision of the quadriceps muscle group may be selected for definitive treatment of intracompartmental soft tissue sarcomas within this muscle group. After a skin incision is made from anterosuperior iliac spine to the patella, skin flaps are dissected superficial to the fascia lata to the flexor muscles laterally and to the gracilis muscle medially. The superficial femoral artery is dissected free of the quadriceps muscles over the entire thigh. The origins of the sartorius, tensor fascia lata, and rectus femoris muscles are transected from their origins on the pelvis, and the vastus lateralis, vastus medialis, and vastus intermedius muscles are transected from their origins on the femur. To free the specimen, the quadriceps femoris tendon is divided just proximal to its attachment to the patella. The gracilis muscle medially and the short head of the biceps muscle laterally are transected at their insertions and secured to the patella. The subcutaneous tissue and skin are closed over generous suction drains. After operation an ankle-foot orthosis is used to provide for relatively unrestricted ambulation.