Reconstruction and limb salvage after resection for malignant bone tumour of the proximal humerus - A sling procedure using a free vascularised fibular graft

We assessed the intermediate functional results of eight patients after nid e resection of the proximal humerus for malignant bone tumour. We used a fr ee vascularised fibular graft as a functional spacer and a sling procedure to preserve passive scapulohumeral movement. Scapulohumeral arthrodesis was not carried out. Five patients had osteosarcoma, two achondrosarcoma and o ne a malignant fibrous histiocytoma of the bone. The mean duration of follo w-up was 70 months (median, 76) for the seven patients who were still alive at the time of the latest follow-up. One patient died from the disease 12 months after surgery. There were no local recurrences. The functional results were described and graded quantitatively according t o the rating system of the Musculoskeletal Tumour Society. Our results were satisfactory with regard to pain, emotional acceptance and manual dexterit y, Function and lifting ability were unsatisfactory in two patients. One pa tient had delayed union between host and graft, but this united after six m onths without further surgery. Radiographs of the shoulder showed absorptio n or collapse of the head of the fibula in four of the eight patients and a fracture in another. No functional problems related to absorption or fract ure of the head of the fibula were noted. There was no infection or subluxa tion of the head, We conclude that this is a reasonably effective technique of limb salvage after resection of the proximal humerus.