Journal international de médecine physique et de réadaptation
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Abstrait

Functional Recovery and Rehabilitation after Popliteal Sarcoma Excision in a Young Woman

Ermes Vedovi

Soft tissue sarcomas represent rare, heterogeneous and complex malignant neoplasm, which require multidisciplinary treatment to improve clinical outcome, survival and quality of life of affected subjects. Whenever possible, limb saving is considered the preferable choice over amputation.

This clinical case describes the surgical intervention and rehabilitative treatment in the case of a young patient suffering of fibromyxoid sarcoma of the popliteal fossa, with the aim of obtaining the best clinical outcome in terms of survival, limb function recovery, walking and the performance in daily living activities.

Design: A single clinical case.

Participant: An active 38-year-old woman affected by fibromyxoid sarcoma of the right popliteal fossa underwent neoadjuvant radio-chemotherapy before surgical excision of the lesion with sacrifice of sciatic nerve and hamstrings, endto- end vascular bypass of the femoral artery and vein with contralateral saphenous graft. Subsequent motor rehabilitation treatment in a sub-intensive regime and evaluation of aids were done.

Rehabilitation exercise program: exercises to improve the range of motion of the hip and knee and strengthen the muscles involved in flexion and abduction of the hip and in flexion and extension of the knee, trying to discourage compensation at the level of the pelvis and spine; multidirectional massage at the level of surgical scars to improve trophism, proprioceptive exercises to facilitate right knee perception control, walking training, initially with the aid of two crutches, then with only one crutch on the right side, stairs training, strategies aimed at recovering autonomy in daily activities.

Conclusion: Demolitive surgery, followed by a well-structured rehabilitation program combined with the use of appropriate aids, was useful to maximize the patient's functional results and provide a satisfactory return to the activities of daily living. Pre-surgical management is desirable to avoid the establishment of abnormal body pattern.