Reconstruction for bone tumours of the shoulder and humerus in children and adolescents

Abstract

Reconstructions for paediatric bone tumours of the shoulder girdle and humerus are intended to optimize placement of the hand in space. Given the longevity of paediatric survivors of sarcoma, durability is an important planning consideration. Here, I review a subset of approaches based on anatomical site with an emphasis on function and longevity. Often, biological reconstructions that combine living bone with tendon repairs and transfers best address those goals.

Effect of implant length variations on stress shielding in proximal humeral replacement after tumor excision under torsion: Finite element study

“…To quantify the stress shielding effect across each implant length, the average percentage change in stress from the intact state across each slice was calculated Equation (1). The cortical and cancellous bone were divided into two sections namely the distal humeral region and the bone-implant interface (Figure 3).…”

“…The proximal humerus is considered as a site vulnerable to primary malignant tumors and metastases in the long bones 1–5 . Osteosarcoma, a primary malignant bone tumor has a bimodal incidence with the first peak observed in adolescence and the second peak seen in the patient group of 50–70 years of age 1,6,7 .…”

“…The proximal humerus is considered as a site vulnerable to primary malignant tumors and metastases in the long bones. [1][2][3][4][5] Osteosarcoma, a primary malignant bone tumor has a bimodal incidence with the first peak observed in adolescence and the second peak seen in the patient group of 50-70 years of age. 1,6,7 Nowadays, limb-sparing surgery has proven to be a safe and routine procedure with 90%-95% of patients with extremity sarcomas undergoing successful treatment in centers specializing in oncologic orthopedic surgery.…”

“…[1][2][3][4][5] Osteosarcoma, a primary malignant bone tumor has a bimodal incidence with the first peak observed in adolescence and the second peak seen in the patient group of 50-70 years of age. 1,6,7 Nowadays, limb-sparing surgery has proven to be a safe and routine procedure with 90%-95% of patients with extremity sarcomas undergoing successful treatment in centers specializing in oncologic orthopedic surgery. 8,9 Endoprosthetic replacement is considered as the preferred reconstructive option for partial resection of long bones such as humerus in lieu of primary amputation to restore joint function and skeletal integrity.…”

Biological Prosthesis (Hollow 3D-Printed Titanium Custom-Made Prosthesis and Bone Graft) for Humeral Reconstruction in Pediatric Oncologic Patients: Surgical Indications and Results

“…Over time, various surgical techniques have been used to reconstruct significant bone defects in children after a wide resection for humeral bone sarcoma. These techniques include biological reconstruction with bone allografts, bone autografts (vascularized fibula or clavicle pro humerus), or free vascularized bone grafts, and extracorporeal irradiated tumor bone have been widely used [5][6][7][8][9].…”