Scapulo-humeral arthrodesis using a pedicled scapular pillar graft following resection of the proximal humerus

Abstract

Level IV (retrospective study).

Is the Clavicula Pro Humero Technique of Value for Reconstruction After Resection of the Proximal Humerus in Children?

“…The choice of the technique in proximal humerus reconstruction after oncologic resection in children is complicated because of the extent of muscle resection, the need for stable reconstruction, and the goal of maximum mobility and sustainability, introducing the concept of fully biological reconstruction of the growing limb for young patients with the potential for long-term survival. Many techniques such as arthrodesis [4,15,24], vascularized fibular epiphysis transfer [20,23], and endoprostheses [1, 2, 5, 10-12, 26, 29, 37] have been described in the adult population and some of these studies include pediatric patients, but the small number of patients makes comparison of different techniques difficult. There is no apparent functional benefit of one type of reconstruction compared with the others that have been described in the adult population [17,20,23,30].…”

“…The main complication was aseptic proximal pseudarthrosis (five patients); other complications included one proximal junction fracture, one clavicle fracture complicated by clavicle osteolysis, one distal junction fracture, one necrosis of the skin paddle of the fibular autograft, one glenoclavicular ossification, and one distal pseudarthrosis complicated by a fracture of this distal junction. Function, as assessed by the MSTS score, was a median of 23 of 30 (range, [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]. The median TESS score was 82% (range, 75%-92%).…”

Malignant tumors of the shoulder girdle: Surgical and functional outcomes

“…The most reliable procedure has been reported to be prosthetic replacement. 3,13,15,17,18 In our study, prosthetic replacement was the most common procedure.…”

“…9,10 This classification has been used in many studies day by day and many reconstruction methods have been described. 4,5,7,[11][12][13][14][15][16][17][18][19] Since the 1990s, the glenoid resection and reconstructions have been defined by preserving the medullary scapula, but neither the resection type nor the clavicle resections have been included in traditional classifications. 3,7,11,12,20 We described a modified classification system.…”

“…9,10 This classification has been used in many studies day by day and many reconstruction methods have been described. 4,5,7,11 –19…”