2022 Volume 1 Issue 4 Pages 337-343
Limb-sparing surgery is important treatment for soft tissue sarcoma, but resection of major muscles in the lower extremities causes motor and gait dysfunction. However, we have experienced limb-sparing patients who have had significant improvement in their ability to walk.
We present the case of a 52-year-old woman who had limb-sparing surgery for soft tissue sarcoma that removed hamstring muscles (biceps femoris, semimembranosus, and semitendinosus). After surgery, the patient suffered from gait disturbance but was able to stabilize her gait by wearing ankle-foot orthosis. The patient underwent knee flexor strength testing and gait analysis with and without the ankle-foot orthosis. The maximum torque of the knee flexor muscles was higher when the patient used the ankle-foot orthosis than without it. Gait analysis demonstrated improvement of knee flexion with the ankle-foot orthosis. The surface electromyogram showed that gastrocnemius activity was increased markedly by using the ankle-foot orthosis.
The ankle-foot orthosis not only fixed the ankle in place to avoid foot drop, but also allowed gastrocnemius to act effectively as a knee flexor muscle after hamstring resection. We recommend using an ankle-foot orthosis to improve the gait of patients who have undergone hamstring resection because of a soft tissue tumor, infection, or trauma.
