Tumor prosthesis replacement in proximal humeral application in the treatment of malignant bone tumor

WANG Yong-gui; LIU Jiang-tao

doi:10.3969/j.issn.2095-252X.2014.07.007

Abstract：Objective To investigate the clinical results of tumor prosthesis replacement in the treatment of malignant bone tumors of the proximal humerus.Methods Clinical data of 32 patients with malignant bone tumors of the proximal humerus who were treated from July 2000 to January 2010 were retrospectively analyzed. There were 10 cases of osteosarcoma, 6 cases of Ewing’s sarcoma, 7 cases of giant cell tumors, 5 cases of metastatic carcinoma and 4 cases of chondrosarcoma. In functional reconstruction of the shoulder joint, the custom artificial tumor prosthesis of the shoulder joint was used. According to Enneking’s functional criteria after the muscular-skeletal tumor surgery, the clinical results were evaluated.Results All the patients were followed up for 4.2 years on average ( range: 3.1-5.3 years ) after the operation. Among them, death occurred in 2 cases, postoperative recurrence in 2 cases, chronic periprosthetic infection in 1 case and shoulder subluxation in 2 cases. The elbow, wrist and hand functions in all the patients were normal. The shoulder abduction was 75° on average ( range: 60°-90° ), the lfexion 45° on average ( range: 35°-55° ), the extension 50° on average ( range: 40°-60° ) and the adduction 17.5° on average ( range: 15°-20° ). According to Enneking’s functional criteria after the muscular-skeletal tumor surgery, the minimum score was 11 points in 2 cases and the maximum score was 28 points in 2 cases. There were 14 cases whose score ranged from 24 points to 30 points, 9 cases from 18 points to 23 points, 7 cases from 12 points to 17 points and 2 cases less than 12 points. The excellent and good rate was 71.9%.Conclusions Artiifcial shoulder joint replacement is an effective method in the treatment of malignant bone tumors of the proximal humerus, because not only the entire appearance of the affected extremity will be kept, but also the function of the upper extremity can be preserved to a great extent.