REPLACEMENT OF THE PROXIMAL HUMERUS IN PRIMARY BONE-TUMORS

Background: Primary bone tumours have traditionally been treated by fo requarter amputation. However, recent limb salvage techniques have bec ome available which are comparable for tumour control and preserve a u seful distal limb. This report describes the use of the Huckstep ceram ic shoulder with ceramic spacers, non-vascularized fibular grafts and Huckstep nail with ceramic spacers. Methods: Three techniques are desc ribed for the reconstruction of the humerus following primary tumour e xcision. The seven primary bone rumours in this series included three patients with osteosarcoma, two with chondrosarcoma, one with fibrosar coma and one with an aneurysmal bone cyst. The mean age of the four ma les and three females was 27 years (range 18-57). Mean follow up was 8 .8 years (range 1-18). The techniques used were the Huckstep ceramic s houlder prosthesis with spacers (three cases), non-vascularized fibula r grafts (three cases) and the Huckstep nail with ceramic spacers (one case). Results: One fibular graft required supplementary bone graftin g and one patient with a shoulder prosthesis died of metastatic diseas e. The other five patients are well with a good range of shoulder abdu ction and external rotation. Conclusions: Limb salvage surgery of the upper limb is possible. Deltoid, rotator cuff and radial nerve functio ns can be preserved.