title: Preliminary results after reconstruction of bony defects of the proximal humerus with an allograft-resurfacing composite.
abstract: We retrospectively studied 14 patients with proximal and diaphyseal tumours and disappearing bone (Gorham's) disease of the humerus treated with wide resection and reconstruction using an allograft-resurfacing composite (ARC). There were ten women and four men, with a mean age of 35 years (8 to 69). At a mean follow-up of 25 months (10 to 89), two patients had a fracture of the allograft. In one of these it was revised with a similar ARC and in the other with an intercalary prosthesis. A further patient had an infection and a fracture of the allograft that was revised with a megaprosthesis. In all patients with an ARC, healing of the ARC-host bone interface was observed. One patient had failure of the locking mechanism of the total elbow replacement. The mean post-operative Musculoskeletal Tumor Society score for the upper extremity was 77% (46.7% to 86.7%), which represents good and excellent results; one patient had a poor result (46.7%). In the short term ARC effectively relieves pain and restores shoulder function in patients with wide resection of the proximal humerus. Fracture and infection remain significant complications.
authors.affiliation: Istituto Ortopedico Rizzoli, 1/10 via di Barbiano, 40136 Bologna, Italy. pietro.ruggieri@ior.it
authors.forename: P
authors.initials: P
authors.lastname: Ruggieri
authors.forename: A F
authors.initials: AF
authors.lastname: Mavrogenis
authors.forename: G
authors.initials: G
authors.lastname: Guerra
authors.forename: M
authors.initials: M
authors.lastname: Mercuri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000601:surgery*; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002484:Cementation; D002648:Child; D005260:Female; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000601:surgery*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010015:Osteolysis, Essential / Q000601:surgery; D011859:Radiography; D020127:Recovery of Function; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome