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Adductor Muscle Group Excision

  • Martin Malawer
  • Paul Sugarbaker
Chapter

Overview

The adductor muscle group is the second most common site for high- and low-grade soft-tissue sarcomas of the thigh. Liposarcoma is the most common tumor arising within this compartment. Although these tumors often become large prior to clinical detection, limb-sparing resection may be safely performed in 90–95% of patients with adductor tumors. Today, induction chemotherapy, radiation therapy, or both permit a safe compartmental or partial muscle group resection for even the largest tumors. Amputation (modified hemipelvectomy) is required if there is intrapelvic extension, superficial femoral artery and vein involvement, or sciatic notch extension and, in rare cases, palliation.

Preoperative staging studies must evaluate the sartorial canal, pelvic floor, medial hamstrings, ischium, psoas muscle, and hip joint. A limb-sparing procedure begins with dissection and preservation of the superficial femoral artery. The profunda femoris artery is ligated. The adductors are then detached from the femur and from its origin along the inferior and superior pubic rami and ischium. Preservation of the sciatic nerve is necessary. Surgical reconstruction of the defect is performed by transferring the sartorius muscle and the remaining medial hamstrings. Functional loss following resection is minimal.

Keywords

Pelvic Floor Sciatic Nerve Superficial Femoral Artery Pelvic Ring Adductor Muscle Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Martin Malawer
  • Paul Sugarbaker

There are no affiliations available

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