ABSTRACT
Posteriorly, it may be difficult to visualize the sciatic nerve. It is useful to do this component of the dissection without muscle relaxation. The reason for this is that one can use either a nerve stimulator or get a sense from the electrocautery of nerve conduction. Once the nerve is identified, it is usually straightforward to dissect in a plane that is away from the nerve. The medial extent of dissection is often along the femur. It is unusual for any soft tissue sarcoma to invade through the periosteum, and every attempt should be made to preserve this in order to reduce the risk of fracture in patients who will be receiving adjuvant radiation. Once the tumor is completely encompassed, it is removed en bloc. Primary closure can virtually always be obtained. The same principles of drain placement apply as for other extremity lesions.
