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Limb sparing surgery for bone tumours of the shoulder girdle: the oncological and functional results

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Abstract

It is a great challenge to spare the upper limb with a malignant or invasive benign bone tumour of the shoulder girdle. We retrospectively analysed 35 patients with bone tumours of the shoulder girdle treated with various limb salvage procedures. The tumours included 25 primary malignancies, three metastases and seven giant cell tumours which involved the proximal humerus in 21 patients, scapula in 12 and clavicle in two. The reconstruction procedures included eight prosthetic replacements, four devitalised tumorous bone grafts, three osteoarticular allografts, two autogenous fibular grafts, one intramedullary cemented nail, three Tikhoff-Linberg procedures, two replantation of shortened arms, and four humeral head suspensions. Six partial scapulectomies and two lateral clavicectomies needed no bone reconstruction. With an average follow-up of 71 months, local recurrences occurred in four cases and systemic metastases in six. Nine patients died and 23 remained disease free. The five year Kaplan-Meier survival rate of 28 patients with malignancies was 69.5%. The average Musculoskeletal Tumour Society (MSTS) functional score was 77% (range 40–100%) in all patients.

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References

  1. Creighton JJ, Peimer CA, Mindell ER, Boone DC, Karacousis CP, Douglass HO (1985) Primary malignant tumors of the upper extremity: retrospective analysis of one hundred twenty-six cases. J Hand Surg [Am] 10:805–814

    Google Scholar 

  2. Malawer MM (1991) Tumors of the shoulder girdle: technique of resection and description of a surgical classification. Orthop Clin North Am 22:7–35

    CAS  PubMed  Google Scholar 

  3. Sim FH, Pritchard DJ, Ivins JC (1977) Forequarter amputation. Orthop Clin North Am 8:921–931

    CAS  PubMed  Google Scholar 

  4. Enneking WF, Dunham W, Gebhardt M, Malawar M et al (1990) A system for the classification of skeletal resections. Chir Organi Mov 75(Suppl 1):217–240

    CAS  PubMed  Google Scholar 

  5. Linberg BE (1928) Interscapulo-thoracic resection for malignant tumors of the shoulder joint region. J Bone Jt Surg 10:344–349

    Google Scholar 

  6. Gibbons CLMH, Bell RS, Wunder JS et al (1998) Function after subtotal scapulectomy for neoplasm of bone and soft tissue. J Bone Jt Surg [Br] 80:38–42

    Article  CAS  Google Scholar 

  7. Mayil Vahanan N, Mohanlal P, Bose JC et al (2007) The functional and oncological results after scapulectomy for scapular tumours: 2–16-year results. Int Orthop 31(6):831–836

    Article  CAS  PubMed  Google Scholar 

  8. Kapoor S, Tiwari A, Kapoor S (2008) Primary tumours and tumorous lesions of clavicle. Int Orthop 32(6):829–834

    Article  PubMed  Google Scholar 

  9. Pritsch T, Bickels J, Wu CC et al (2007) Is scapular endoprosthesis functionally superior to humeral suspension? Clin Orthop Relat Res 456(5):188–195

    Article  PubMed  Google Scholar 

  10. Getty PJ, Peabody TD (1999) Complications and functional outcomes of reconstruction with an osteoarticular allograft after intra-articular resection of the proximal aspect of the humerus. J Bone Jt Surg [Am] 81(8):1138–1146

    CAS  Google Scholar 

  11. Rödl RW, Ozaki T, Hoffmann C et al (2000) Osteoarticular allograft in surgery for high-grade malignant tumours of bone. J Bone Jt Surg [Br] 82(7):1006–1010

    Article  Google Scholar 

  12. Kitagawa Y, Thai DM, Choong PF (2007) Reconstructions of the shoulder following tumour resection. J Orthop Surg (Hong Kong) 15(2):201–206

    CAS  Google Scholar 

  13. Rödl RW, Gosheger G, Gebert C et al (2002) Reconstruction of the proximal humerus after wide resection of tumours. J Bone Jt Surg [Br] 84(7):1004–1008

    Article  Google Scholar 

  14. Tsukushi S, Nishida Y, Takahashi M et al (2006) Clavicula pro humero reconstruction after wide resection of the proximal humerus. Clin Orthop Relat Res 447:132–137

    Article  PubMed  Google Scholar 

  15. Krieg AH, Hefti F (2007) Reconstruction with non-vascularised fibular grafts after resection of bone tumours. J Bone Jt Surg [Br] 89(2):215–221

    Article  CAS  Google Scholar 

  16. Wada T, Usui M, Isu K et al (1999) Reconstruction and limb salvage after resection for malignant bone tumour of the proximal humerus. A sling procedure using a free vascularised fibular graft. J Bone Jt Surg [Br] 81(5):808–813

    Article  CAS  Google Scholar 

  17. Kassab M, Dumaine V, Babinet A et al (2005) Twenty nine shoulder reconstructions after resection of the proximal humerus for neoplasm with mean 7-year follow-up. Rev Chir Orthop Reparatrice Appar Mot 91(1):15–23

    CAS  PubMed  Google Scholar 

  18. Springfield DS (1997) Orthopaedic oncology. In: Sledge CB, Poss RP (eds) The year book of orthopedics. Mosby, St Louis, pp 98–100

    Google Scholar 

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Correspondence to Jianmin Li.

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Yang, Q., Li, J., Yang, Z. et al. Limb sparing surgery for bone tumours of the shoulder girdle: the oncological and functional results. International Orthopaedics (SICOT) 34, 869–875 (2010). https://doi.org/10.1007/s00264-009-0857-3

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  • DOI: https://doi.org/10.1007/s00264-009-0857-3

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