Replacement of the proximal humerus in primary bone tumours.
BACKGROUND
Primary bone tumours have traditionally been treated by forequarter amputation. However, recent limb salvage techniques have become available which are comparable for tumour control and preserve a useful distal limb. This report describes the use of the Huckstep ceramic shoulder with ceramic spacers, non-vascularized fibular grafts and Huckstep nail with ceramic spacers.


METHODS
Three techniques are described for the reconstruction of the humerus following primary tumour excision. The seven primary bone tumours in this series included three patients with osteosarcoma, two with chondrosarcoma, one with fibrosarcoma and one with an aneurysmal bone cyst. The mean age of the four males and three females was 27 years (range 18-57). Mean follow up was 8.8 years (range 1-18). The techniques used were the Huckstep ceramic shoulder prosthesis with spacers (three cases), non-vascularized fibular grafts (three cases) and the Huckstep nail with ceramic spacers (one case).


RESULTS
One fibular graft required supplementary bone grafting and one patient with a shoulder prosthesis died of metastatic disease. The other five patients are well with a good range of shoulder abduction and external rotation.


CONCLUSIONS
Limb salvage surgery of the upper limb is possible. Deltoid, rotator cuff and radial nerve functions can be preserved.
Huckstep
R L
RL
Department of Traumatic and Orthopaedic Surgery, University of New South Wales, Australia.
Sherry
E
E
D000293:Adolescent; D000328:Adult; D017824:Bone Cysts, Aneurysmal / Q000601:surgery*; D001858:Bone Nails; D001859:Bone Neoplasms / Q000601:surgery*; D002516:Ceramics; D002813:Chondrosarcoma / Q000601:surgery*; D005260:Female; D005360:Fibula / Q000637:transplantation; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000601:surgery; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000601:surgery*; D011182:Postoperative Care; D012785:Shoulder Joint; D013997:Time Factors