title: Endoprosthetic replacement of the humerus combined with trapezius and latissimus dorsi transfer: a report of three patients.
abstract: BACKGROUND
  To improve the functional outcome after proximal and/or total humerus replacement, we combined the surgical procedures described by Bateman and Gerber.
  
  
  METHODS
  In three patients after wide tumor resection, endoprosthetic replacement with a modular tumor endoprosthesis (MUTARS System) was performed. In addition to a capsular and muscular reconstruction using the Trevira tube, a trapezius transfer onto the Trevira tube in combination with a latissimus dorsi transfer onto the Trevira tube was performed. The patients were immobilized for 6 weeks after surgery with an abductor cast.
  
  
  RESULTS
  After a follow-up of 1 year, there was no significant improvement of the shoulder function in comparison with patients who did not undergo the combined muscle transfer (control group n=16: mean abduction 37.5 degrees ; mean anteversion 35.0 degrees ; mean internal rotation 15.2 degrees ; mean external rotation 25.2 degrees ).
  
  
  CONCLUSIONS
  In our patients, the combination of the Gerber and the Bateman procedures did not improve the shoulder function in patients with proximal and/or total humerus replacements. Therefore, the functional results do not justify two separate approaches and a prolonged operation time.
authors.affiliation: Department of Orthopaedics, Westfaelische Wilhelms-Universitaet Muenster, Albert-Schweitzer-Strasse 33, 48149, Münster, Germany. goshegg@uni-muenster.de
authors.forename: G
authors.initials: G
authors.lastname: Gosheger
authors.forename: J
authors.initials: J
authors.lastname: Hardes
authors.forename: H
authors.initials: H
authors.lastname: Ahrens
authors.forename: C
authors.initials: C
authors.lastname: Gebert
authors.forename: W
authors.initials: W
authors.lastname: Winkelmann
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000601:surgery*; D016022:Case-Control Studies; D002370:Casts, Surgical; D002648:Child; D004551:Elbow Joint / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D006811:Humerus / Q000601:surgery*; D017746:Joint Capsule / Q000601:surgery; D012516:Osteosarcoma / Q000601:surgery*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D016059:Range of Motion, Articular / Q000502:physiology; D013709:Tendon Transfer