Practice Patterns Vary Among Orthopedic, Plastic, and General Surgeons Resecting Soft Tissue Tumors of the Extremities and Pelvis.

backgroundResection of extremity soft tissue tumors is common and frequently performed by orthopedic, plastic, and general surgeons. It is unknown if tumor location, Preoperative workup, and Postoperative care varies by specialty, which is the aim of this study.

methodsA retrospective review was performed of 4,223 soft tissue tumors resected from the extremities and pelvis within a large single-state health system between 2009 and 2019. A more detailed cross-sectional review was performed on 450 tumors resected in 2016. Demographic and tumor characteristics, surgeon specialty (orthopedic, plastic, general), Preoperative workup (imaging, biopsy), and Postoperative management were collected and analyzed.

resultsGeneral surgeons were more likely to resect tumors superficial to fascia (82.1%), compared to plastic and orthopedic surgeons (53.7% and 27.9%). Orthopedic surgeons were more likely to resect malignant tumors (28.2%) than plastic and general surgeons (14.0% and 4.5%). 16.3% of tumors resected by general surgeons had either Preoperative MRI or tissue diagnosis, compared to 42.6% for plastic surgeons and 90.5% for orthopedic surgeons (p < 0.001). Of the tumors resected by general surgeons without Preoperative MRI or tissue diagnosis, 2.6% were malignant. Finally, Postoperative documentation of neurovascular status, range of motion, and referral to physical therapy were more likely performed by orthopedic surgeons (all p < 0.001).

conclusionPractice patterns vary significantly among orthopedic, plastic, and general surgeons treating soft tissue tumors of the extremities and pelvis. These findings highlight the need for multidisciplinary engagement and standardization of treatment algorithms and training practices across the various surgical specialties.