Modular prostheses in the treatment of proximal humerus metastases: review of 40 cases

Background The humerus is the second most common site of metastatic bone disease involving long bones. Tumors which have a predilection for dissemination to bone are those of breast, prostate, thyroid, lung and kidney. The rationale for surgical treatment of these lesions is to prevent or treat path...

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Bibliographic Details
Published in:Journal of orthopaedics and traumatology 2008-03, Vol.9 (1), p.5-10
Main Authors: Scotti, C., Camnasio, F., Peretti, G. M., Fontana, F., Fraschini, G.
Format: Article
Language:English
Subjects:
Bone diseases
Bone tumors
Bones
Conservative Orthopedics
Fractures
Humerus
Long bone
Medicine
Medicine & Public Health
Metastases
Metastasis
Original
Orthopedics
Osteoporosis
Pain
Prostheses
Prosthetics
Quality of life
Rheumatology
Sports Medicine
Surgical Orthopedics
Survival
Thyroid
Traumatic Surgery
Tumors
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Summary:Background The humerus is the second most common site of metastatic bone disease involving long bones. Tumors which have a predilection for dissemination to bone are those of breast, prostate, thyroid, lung and kidney. The rationale for surgical treatment of these lesions is to prevent or treat pathological fractures in order to relieve pain and improve function. Materials and methods Forty patients who had resection of the proximal humerus for metastatic bone disease and reconstruction with a modular prosthesis were retrospectively reviewed. Results Mean functional outcome was 73.1% (Enneking score) and better results were achieved when a reverse prosthesis was implanted. Overall survival was 70% at 1 year, 42.5% at 2 years and 20% at 5 years. Local recurrence occurred in 4 patients, each of whom had initially been treated for a pathological fracture. Conclusions It is important to follow rational guidelines, like those of Capanna and Mirels, in order to prevent pathological fractures and to give the patient a definitive treatment, as the advances in the management of cancer prolong the survival of these patients. In this series, satisfactory results were obtained, giving the patients an acceptable quality of life.
ISSN:1590-9921
1590-9999
DOI:10.1007/s10195-008-0097-0