title: Proximal humerus allograft prosthetic composites: technique, outcomes, and pearls and pitfalls.
abstract: The proximal humerus is the second most common location of primary bone sarcomas and a frequent location of benign locally aggressive primary osseous tumors. In contrast to other locations, tumors in this region impose significant challenges for local control and reconstruction. This is due to glenohumeral joint anatomic characteristics such as lack of intrinsic stability and dependence on dynamic and static stabilizers. In addition, the close proximity of the axillary nerve and axillary vascular bundle places these at risk of resection when attaining local control. Allograft prosthetic composites (APCs) of the proximal humerus are one of the methods for mobile reconstruction. This modality presents lower fracture rates when compared to osteoarticular allografts and lower rates of subluxation and instability than endoprosthesis. Recent literature documents a trend for superior functional outcome at comparable complication rates. APC reconstruction is an important tool in the orthopedic oncologist armamentarium.
authors.affiliation: Department of Orthopaedic Surgery, Musculoskeletal Oncology Service, Beth Israel Deaconess Medical Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. SLOZANOCALDERON@mgh.harvard.edu.
authors.forename: Santiago A
authors.initials: SA
authors.lastname: Lozano-Calderón
authors.affiliation: Department of Orthopaedic Surgery, Hand and Upper Extremity Service Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Neal
authors.initials: N
authors.lastname: Chen
keywords: Allograft; Prosthetic composite; Proximal humerus; Reconstruction