上腕骨原発性悪性腫ように対する患肢温存手術の経験

Abstract

For malignant bone tumors of the proximal humerus, limb-saving surgery by resection alone is likely to discard the shoulder function. Resection of the proximal and diaphyseal humerus was performed in a 14-year-old girl with osteosarcoma, whose shoulder and elbow became totally useless. For another osteosarcoma case (a 19-year-old boy), vascularized fibular graft was performed after failed endprosthetic replacement. However, the grafted fibula proximally underwent avascular necrosis. Finally, shoulder arthrodesis was successfully performed by additional vascularized fibular graft and a long plate. For Ewing's sarcoma in a 5-year-old boy, vascularized fibular graft preserving epiphyseal plate was performed. However, pseudarthrodesis and closure of the epiphysis were evidenced in one year.Arthrodesis of the shoulder probably provides more stability and useful motion than other limbsaving procedures.