2000 Volume 24 Issue 3 Pages 515-519
The purpose of this report was to evaluate the limb salvage operations following a scapulohumeral resection with a deltoid resection for “clinically malignant tumors” of the proximal humerus.
Case I. The radiogran of a 39-year-old-woman showed destruction of the proximal humerus. A histological diagnosis was a grade I chondrosarcoma. The proximal half of the humerus, the lateral one third of the scapula and the deltoid muscle with the surrounding muscles were resected. Arthroplasty without a glenoid component was performed.
Case II. The invasion of a tumor into the glenohumeral joint and the deltoid muscle were found in CTs and MRIs of a 54-old-man. The histological diagnosis was a giant cell tumor. The proximal half of the humerus, the scapular bone from the grenoid to the scapular neck, and the deltoid muscle with the surrounding muscles were resected.An arthrodesis was performed by using a free fibula graft with the iliac bone. The skin defect was closed by a muscloctaneous graft.
Two ways of reconstruction usually exist. One is an arthroplasty, and the other is an arthrodesis.
An arthrodesis is preferable without an abductor mechanism. An arthroplasty without a glenoid component was performed in case I under the circumstances without an abductor mechanism, because the scapular neck which is important to fix a fibula graft was resected. An arthrodesis was chosen in Case II by using a free fibula graft. The bone union was delayed. This could be the result of a soft tissue absence to contribute to the local blood supply. The two salvaged limbs were functionally limited. However, we assure these procedures, which are a curative wide margin resection, prevent humeral bone tumor from recurrence and protect the function of the elbow and fingers.
