title: [Endoprosthetic reconstruction of the proximal humerus in malignoma].
abstract: OBJECTIVE
  The aim of the operation is local tumor control in malignant primary and secondary bone tumors of the proximal humerus. Limb salvage and preservation of function with the ability to lift the hand to the mouth. Stable suspension of the arm in the shoulder joint or the artificial joint.
  
  
  METHODS
  Primary malignant bone tumors of the proximal humerus or the scapula with joint infiltration but without involvement of the vessel/nerve bundle. Metastases of solid tumors with osteolytic defects in palliative or curative intention or after failure of primary osteosynthesis.
  
  
  METHODS
  Tumor infiltration of the vessel/nerve bundle. Massive tumor infiltration of the soft tissues without the possibility of sufficient soft tissue coverage of the implant.
  
  
  METHODS
  Transdeltoid approach with splitting of the deltoid muscle. Preparation and removal of the tumor-bearing humerus with exposure of the vessel/nerve bundle. Ensure an oncologically sufficient soft tissue and bone margin in all directions of the resection. Cementless or cemented stem implantation. Reconstruction of the joint capsule and fixation of the prosthesis using a synthetic tube. Soft tissue coverage of the prosthesis with anatomical positioning of the muscle to regain function.                                               POSTOPERATIVE TREATMENT:                          Immobilization of the arm/shoulder joint for 4-6 weeks in a Gilchrist bandage. Passive mobilization of the elbow joint after 3-4 weeks. Active mobilization of the shoulder and elbow joint at the earliest after 4-6 weeks.
authors: Klinik und Poliklinik für allgemeine Orthopädie und Tumororthopädie, Universitätsklinikum Münster, Albert-Schweitzer-Str. 33, 48149, Münster, Deutschland. streitb@ukmuenster.de
authors: A
authors: A
authors: Streitbürger
authors: M
authors: M
authors: Henrichs
authors: J
authors: J
authors: Hardes
authors: R
authors: R
authors: Dieckmann
authors: S
authors: S
authors: Hoell
authors: G
authors: G
authors: Gosheger
mesh_terms: D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods*; D001859:Bone Neoplasms / Q000601:surgery*; D006801:Humans; D006811:Humerus / Q000601:surgery*; D007595:Joint Prosthesis; D023821:Limb Salvage / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012785:Shoulder Joint / Q000601:surgery*