Outcomes of Oncologic Total Humeral Reconstruction

Abstract

Background/aim: The humerus is the most common site for malignant tumors in the upper extremity. Rarely, a total humeral resection with combined replacements of both the shoulder and the elbow are necessary. The aim of this study was to evaluate outcomes after total humeral reconstruction at our institution.

Patients and methods: Nine patients (5 females, 4 males, mean age 48±26 years) with a malignant tumor of the humerus were included in this study. This included five endoprostheses and four allograft prosthetic composites.

Results: Postoperative complications occurred in eight patients, most commonly deep vein thrombosis (DVT, n=3) and elbow contractures (n=3). Complications led to a revision procedure in one patient, with a cumulative incidence of failure of 25% at 5-years and a 5-year overall patient survival rate of 13%. At the most recent follow-up, the median Musculoskeletal Tumor Society Score was 50%.

Conclusion: Total humerus reconstruction is a rare surgical procedure that is associated with a high rate of complications with relatively poor functional outcomes. However, this option does offer a means of limb salvage for patients with limited options.

Keywords: Total humerus; allograft prosthetic composite; endoprosthesis; upper extremity.