Application of Prosthesis Replacement in Limb Salvage Treatment of Malignant Bone Tumors in Proximal Humerus

Objective To evaluate the curative effect of prosthetic replacement in limb salvage treatment of malignant bone tumors in proximal humerus.Methods From February 2000 to February 2009,16 patients with malignant tumors in the proximal humerus underwent limb salvage with prosthetic replacement.There were 10 male patients and 6 female patients.The age of patientd ranged from 14～56 years old(average age is 27.3).The pathological diagnosis results confirmed that 10 patients with osteosarcoma,1 patient with malignant fibrous histiocytoma,1 patient with Ewing's sarcoma,and 4 patients with giant cell tumor.According to Campanicci grading system,4 patients were in Ⅲ grade.According to Enneking grading system,2 patients were in Ⅱa stage and 10 patients were in Ⅱb stage.All patients except patients with bone giant cell tumor were given neo-adjuvant chemotherapy and postoperative adjuvant chemotherapy.Results The average follow-up time of patients were 32 months(6months to 84 months).No complications including infection,loosening and fracture happened in patients with prosthetic replacement.The incomplete dislocation of artificial should joint happened in 2 patients(12.5%,2/16).The function were assessed by International Society of Limb Salvage System(ISOLS),the functional scores of reconstructed shoulder joint were at least 24 in 13 cases.It was 81.3% that superior rate of the function of the afffected limb.Conclusion It is an efficacious method for treatment of malignant tumors in proximal humerus by using prosthetic replacement which can reduce complication after operation,and the function of reconstructed shoulder joint is satisfied.