Clavicula pro humero reconstruction after wide resection of the proximal humerus.

Abstract

The optimal reconstruction procedure after resection of proximal humeral bone tumors is controversial. We performed clavicula pro humero reconstruction in seven consecutive patients after wide resection of malignant proximal humerus tumors to determine the functional outcomes and to clarify whether this procedure could reduce the occurrence of complications. The histologic diagnoses were conventional osteosarcoma in four patients, chondrosarcoma in two, and parosteal osteosarcoma in one. Postoperative function was assessed with the Musculoskeletal Tumor Society upper extremities scale and an evaluation chart for activities of daily living. The mean Musculoskeletal Tumor Society score was 69%. Stable results were obtained regardless of the extent of the resection, and the results as a flail shoulder were satisfactory. The mean daily activity rating was approximately 80%. The activities of daily living functional rating was better (92%) when the nondominant hand was affected compared with the dominant hand (69%). Bony union was achieved in all seven patients. We observed no instances of infection, fracture, or nonunion. The clavicula pro humero reconstruction is a useful procedure that could reduce the occurrence of complications, especially in young patients and in patients with involvement of the nondominant arm.