我们描述了一个大腿平滑肌肉瘤的病例,切除所有的前肌室,和膝盖伸展的复活，使用背阔肌（LD）游离皮瓣和肌腱转移。描述了手术技术和术后护理管理。功能结果，神经性疼痛,在出院后3个月和12个月评估活动范围（ROM）。尽管发生了血清肿感染，但仍进行了完全切除（R0）并获得了快速的伤口愈合。患者在手术后3个月能够在没有技术支持的情况下行走，也不能行。患者在12个月随访时仍处于缓解状态，医学研究理事会（MRC）量表评估为4/5，ROM评分为5-105°。在股四头肌全切术的情况下，可以通过肌腱转移和神经支配的游离肌皮瓣获得膝关节伸展重建。结合这些技术可能是快速恢复的好策略，具有最佳的疤痕和组织覆盖率。
We describe a
case of a leiomyosarcoma of the thigh, the resection of all the anterior muscular compartment, and the reanimation of knee extension, using a latissimus dorsi (LD) free flap and tendon transfer. Surgical technique and postoperative care management are described. Functional results, neuropathic pain, and range of motion (ROM) were assessed at 3 months and 12 months after discharge. A complete excision (R0) was carried out and rapid wound healing was obtained despite developing a seroma infection. The patient was able to walk without technical support nor limping at 3 months post-surgery. The patient was still in remission at 12 months follow-up, with Medical Research Council (MRC) scale assessed at 4/5 and ROM rated at 5-105°. In
case of total quadriceps resection, knee extension reconstruction can be obtained with tendon transfers and reinnervated free muscular flaps. Combining these techniques could be a good strategy for rapid recovery, with optimal scarring and tissue coverage.
