Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015:2015:690159.
doi: 10.1155/2015/690159. Epub 2015 May 18.

Expandable Total Humeral Replacement in a Child with Osteosarcoma

Eric R Henderson  1 , Jidi Gao  2 , John Groundland  3 , Odion Binitie  4 , G Douglas Letson  4
Affiliations

Expandable Total Humeral Replacement in a Child with Osteosarcoma

Eric R Henderson et al. Case Rep Orthop. 2015.

Abstract

Case. A right-handed 8-year-old female patient presented with a conventional, high-grade osteosarcoma involving her right humerus; through-shoulder amputation was recommended. After consultation, total humerus resection with expandable, total humeral endoprosthesis reconstruction was performed with a sleeve to encourage soft-tissue ingrowth. At three-year follow-up she has received one lengthening procedure and her functional scores are excellent. Conclusion. Total humeral resection and replacement in the pediatric population are rare and although early reports of expandable total humeral endoprosthesis outcomes demonstrate high failure rates, this patient's success indicates that expandable total humeral replacement is a viable option.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Anteroposterior radiograph of humerus following neoadjuvant chemotherapy for osteosarcoma.
Figure 2
Figure 2
MRI of humerus demonstrating osteosarcoma lesion.
Figure 3
Figure 3
Surgical approach to the proximal humerus.
Figure 4
Figure 4
Total humeral surgical specimen following dissection.
Figure 5
Figure 5
Total humeral surgical specimen and expandable total humeral endoprosthesis.
Figure 6
Figure 6
Preserved rotator cuff and shoulder joint capsule marked with tag sutures.
Figure 7
Figure 7
Placement of suture anchors about glenoid neck.
Figure 8
Figure 8
Vascular graft being positioned over glenoid prior to placement of endoprosthesis.
Figure 9
Figure 9
Endoprosthesis following ulnar cementation, suturing of rotator cuff to vascular graft, and imbrication of the vascular graft with nonabsorbable sutures.
Figure 10
Figure 10
Postoperative anteroposterior humeral radiograph with implanted endoprosthesis.
See this image and copyright information in PMC

References

    1. Pritchett J. W. Growth and predictions of growth in the upper extremity. The Journal of Bone and Joint Surgery—American Volume. 1988;70(4):520–525. - PubMed
    1. Simon M. A. Limb salvage for osteosarcoma in the 1980s. Clinical Orthopaedics and Related Research. 1991;(270):264–270. - PubMed
    1. Henderson E. R., Groundland J. S., Pala E., et al. Failure mode classification for tumor endoprostheses: retrospective review of five institutions and a literature review. The Journal of Bone and Joint Surgery. 2011;93(5):418–429. doi: 10.2106/jbjs.j.00834. - DOI - PubMed
    1. Scales J. T., Sneath R. S., Wright K. Limb Salvage in Musculoskeletal Oncology. New York, NY, USA: Churchill Livingstone; 1987. Design and clinical use of extending prostheses; pp. 52–61.
    1. Abudu A., Grimer R., Tillman R., Carter S. The use of prostheses in skeletally immature patients. Orthopedic Clinics of North America. 2006;37(1):75–84. doi: 10.1016/j.ocl.2005.08.008. - DOI - PubMed