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Proximal Humerus Resection. The Tikhoff-Linberg Procedure and its Modifications

  • Martin Malawer
  • James Wittig

Overview

The proximal humerus is a common site for primary osteosarcomas as well as chondrosarcomas. Metastatic tumors occasionally involve the shoulder girdle and are often treated using the same resection and reconstruction techniques. Limb-sparing resection of the proximal humerus is challenging. Despite theircomplexity, these resections can be performed in approximately 95% of patients with high- or low-grade sarcomas. Amputations are rarely required.

Endoprosthetic reconstruction is the most common technique for reconstructing large proximal humeral defects. It is used following both intra-articular (Type I) and extra-articular (Type V) resections (see Chapter 9). This is combined with local muscle transfers to create shoulder stability, cover the prosthesis, and provide a functional elbow, wrist, and hand.

The surgical and anatomic considerations of limb-sparing procedures of the proximal humerus and the specific surgical techniques of intra- (Type I) and extra-articular (Type V) resection and reconstruction are described in this chapter. Total humeral replacement is briefly described.

Keywords

Brachial Plexus Proximal Humerus Neurovascular Bundle Coracoid Process Pectoralis Major Muscle 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Malawer MM, Link M, Donaldson S. Sarcomas of bone. In: Devita VT, Hellman S, Rosenberg SA, editors. Cancer: Principles and Practice of Oncology, 3rd edn. Philadelphia: JB Lippincott; 1989.Google Scholar
  2. 2.
    Malawer MM, Sugarbaker PH, Lambert MH et al. The Tikhoff-Linberg procedure and its modifications. In: Sugarbaker PH, editor. Atlas of Sarcoma Surgery. Philadelphia: JB Lippincott; 1984.Google Scholar

Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Martin Malawer
  • James Wittig

There are no affiliations available

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