W. Wozniak et al., MALIGNANT HUMERAL BONE-TUMORS IN CHILDREN - EXCISION AND RECONSTRUCTION WITH THE USE OF ROTATED CLAVICLE, Journal of surgical oncology, 62(3), 1996, pp. 183-185
The application of intensive multimodality therapy has made possible s
alvage surgery in bone tumors. Reconstruction of the removed part of b
one is the great problem, especially in fast-growing children. In thre
e patients (two osteosarcomas and one Ewing's sarcoma), the tumor was
confined to the proximal half part of humerus, without invasion of sho
ulder joint. After induction chemotherapy, reduction of tumor size was
observed both clinically and radiologically. During the operation, wi
de resection of the tumor together with a 12- to 14-cm-long fragment o
f humerus, was performed. Afterward, the clavicle was rotated in the p
lace of the removed bone, with preservation of the coracoacromial liga
ment. The humeral stump and clavicle were fixed with the use of metal
plate. Adjuvant chemotherapy was used a few days following surgery. Af
ter 3 months, the osteosynthesis had healed. The movements in shoulder
joint are limited, but functions of elbow joint remained normal. All
children are alive and disease free. Reconstruction of humerus with cl
avicle rotation is possible when the proximal bone loss is not longer
than 10-14 cm. This method seems to be an alternative to allogeneic gr
afts and endoprostheses. (C) 1996 Wiley-Liss, Inc.