Wide Resection for Pediatric Extremity Vascular Malformation-A Tertiary Hospital's Experience

J Pediatr Orthop. 2024 Jan 1;44(1):55-60. doi: 10.1097/BPO.0000000000002546. Epub 2023 Oct 9.

Abstract

Background: Vascular malformations of the extremities (VM) are common benign lesions that tend to grow throughout the patient's lifetime. They can cause various issues like pain, swelling, and even limb length discrepancies. Sclerotherapy was the preferred treatment choice in previous studies. However, sclerotherapy and many other treatments have the potential to result in higher recurrence rates. Surgical treatment has been shown to be effective and safe in many cases. Hence, this study aims to evaluate the suitability of wide resection surgery for VM to reduce recurrence.

Methods: Fort-seven VM cases that underwent wide resection were identified retrospectively in the institution of study. Demographics, depth of malformation, whether malformations were local or diffuse, location and size of malformations, and histology records were taken note of. Records of recurrence and postoperative function were also gathered. We utilized self-reported questionnaires, QuickDASH and Lower Extremity Functional Scale, to determine patients' postsurgical physical function.

Results: Out of 47 cases that underwent wide resection, we found a recurrence rate of 2.1%. No patients sustained any loss of function postsurgery, with few patients experiencing minor complications like tenderness, hypertrophic scars/keloids, as well as numbness. Good functionality posttreatment was also seen through self-reported questionnaires, with an average score of 2.12 for QuickDASH and 99.96% for LEFS.

Conclusion: Where margins can be obtained without functional impairment, surgical-wide resection for VM is a viable treatment option to minimize recurrence.

Level of evidence: Level-IV.

MeSH terms

  • Child
  • Extremities / surgery
  • Humans
  • Retrospective Studies
  • Tertiary Care Centers
  • Treatment Outcome
  • Vascular Malformations* / surgery