The methods of limb-salvage operations for malignant bone tumors are diverse. For proximal humerus, limb-salvage is better than amputation as functional disturbances are serious. We report a case of limb-salvage operation with extensive resection and reconstruction using scapular bone flap for the osteosarcoma of the right proximal humerus.
The case was a 20-year-old man. He was operated after neoadjuvant chemotherapy in August 2001.
The operation consisted of extensive resection (glenoid-humeral shaft bone with around soft tissues resection), reconstruction that returned back the glenoid-humeral shaft bone treated with the Pasteur method and in-lay grafted with scapular bone flap, and lattismus dorsi musclocutaneous flap addition. He had postoperative infection with MRSA and P. aeruginosa but recovered by medication using only antibiotics and local irrigation. Adjuvant chemotherapy was completed in July 2002.
One year after operation, he had only shoulder dysfunction in his right upper extremity with no local recurrence and metastasis.
We recommend scapular bone flap for the osteosarcoma of the right proximal humerus to allow some blood flow of the flap without defects in other sites.