FIBROHISTIOCYTIC SARCOMA OF THE THUMB TREATED BY WIDE RESECTION AND IMMEDIATE FREE-FLAP RECONSTRUCTION - CASE-REPORT

A 29 year old surgical resident presented with a fibrohistiocytic sarc oma over the thumb of his dominant right hand. The tumour was widely e xcised including the ulnar neurovascular bundle. The resultant defect was immediately reconstructed with a sensory forearm free flap from th e opposite upper extremity. The patient was then given a curative dose of cobalt-60 radiotherapy starting in the fourth postoperative week. With a comprehensive regimen of physiotherapy and splinting, the patie nt regained an almost full range of movement in his right thumb and wa s able to resume his regular duties in the operating theatre two month s after his operation. Soft tissue sarcomas of the hand are a real the rapeutic challenge. Adequate control of the tumour in most instances r equires amputation because limb sparing procedures require soft tissue coverage not available locally or achieved easily. In addition, prese rvation of a hand, or parts of it, with poor functional capacity, is n ot helpful.