Retrospective comparative study of conventional arthrodesis versus clavicula pro humero for shoulder reconstruction after wide resection of malignant bone tumor of the proximal humerus

Abstract

Background: The proximal humerus represents one of the most common sites for primary malignant bone tumors. Limb salvage procedures have become the standard modality in treatment of these tumors. Several techniques can be used in shoulder reconstruction after wide resection of malignant bone tumors. The purpose of this study was to compare the functional outcome and complications for two important methods of shoulder joint reconstruction: conventional arthrodesis using fibular autogenous graft and clavicula pro humero. Methods: We retrospectively studied 30 patients with malignant tumors of the proximal humerus treated with limb salvage procedures with mean follow-up period of 67.16 mo. In 13 we used the clavicula pro humerus technique for reconstruction, and in 17 we performed conventional shoulder arthrodesis using nonvascularized fibular graft. Results: The mean Musculoskeletal Tumor Score (MSTS) for the conventional shoulder arthrodesis group was 69.6%. For the clavicula-pro-humero group the score was 67.5%. The Oxford Shoulder Score (OSS) for the conventional shoulder arthrodesis group was 34.6, while for the clavicula-pro-humero group it was 36.8. The median time to union was 8 wk for both groups. Conclusions: Both techniques represent reliable methods of shoulder reconstruction after wide resection of malignant tumors with comparable functional outcome and complications rates.