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.
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References
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.
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.
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© 2004 Kluwer Academic Publishers
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Malawer, M., Wittig, J. (2004). Proximal Humerus Resection. The Tikhoff-Linberg Procedure and its Modifications. In: Musculoskeletal Cancer Surgery. Springer, Dordrecht. https://doi.org/10.1007/0-306-48407-2_33
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DOI: https://doi.org/10.1007/0-306-48407-2_33
Publisher Name: Springer, Dordrecht
Print ISBN: 978-0-7923-6394-1
Online ISBN: 978-0-306-48407-0
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