The Hip: Preservation, Replacement and Revision

Tumors of the Proximal Humerus / Scapula



          - Osteosarcoma (common)
          - Enchondroma (relatively common)
          - Ewing's sarcoma: diaphyseal region;
          - Periosteal chondroma (just proximal to insertion of deltoid)
          - Osteochondroma
          - Chondroblastoma
          - Chondromyxoid fibroma
          - Aneurysmal bone cyst
          - Simple bone cyst
          - Giant Cell Tumor of Bone;
          - Chondrosarcoma: (affects the shoulder girdle)
          - Fibrous Histiocytoma
          - Fibrosarcoma of bone;
          - Plasmacytoma:
          - Renal Cell Ca:
         
- Tumors of the Scapula:
    - Osteochondroma (Osteocartilaginous Exostosis)
    - chondrosarcoma: affects the shoulder girdle;

- Metastatic Tumors of Humerus:
    - aproximately 18.5% of Breast cancer patients develop evidence of humeral metastatic involvement;
    - references:
          - Pathologic fracture of the humerus.
          - A Biomechanical Analysis of Prophylactic Fixation for Pathological Fractures of the Distal Third of the Humerus.
          - Metastatic diaphyseal fractures of the shaft of the humerus. The structural strength evaluation of a new method of treatment with a segmental defect prosthesis.
          - Metastatic bone disease. A study of the surgical treatment of 166 pathologic humeral and femoral fractures.
          - Treatment of pathologic fracture of the humerus.

- Biopsy of Shoulder Lesions:
    - bx of humerus thru deltopectoral interval causes dissemination of tumor cells at a distance, through normal neurovascular planes;
    - following such a biopsy approach, local resection of proximal aspect of humerus is more prone to be followed by a local recurrence;
    - it would be more appropriate to biopsy the tumor through anterior deltoid muscle and then to resect en bloc biopsy-contaminated
           deltoid with the humerus during the definitive procedure



Osteoarticular allografts for reconstruction in the proximal part of the humerus after excision of a musculoskeletal tumor.

Stabilization and prosthetic replacement in difficult fractures and bone tumors.

Resection of malignant bone tumors about the shoulder. A preliminary report of reconstruction with a new modular spacer.

Scapular allografts. A report of two cases.

Interscapulo-Thoracic Resection for Malignant Tumors of the Shoulder Joint Region.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Wednesday, June 20, 2012 2:46 pm