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Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2002, Number 6

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Acta Ortop Mex 2002; 16 (6)

Tumors of the humerus. Preservation surgery with arthroplasty

Moreno HLF, Tecualt GR, Morfín PA, Padilla LR, Amaya ZRA, Moreno WE

Language: Spanish
References: 38
Page: 296-306
PDF size: 174.41 Kb.


ABSTRACT

A retrospective revision of 31 mature patients with tumors in the proximal end of the humerus was carried out from 1990 to 1997. The tumors were classified as type 3 to III B (aggressive and extracompartamental metastatic); in all, wide tumoral resection was practiced, being substituted by prosthetic implants: 28 cases with isoelastic Robert-Mathys prosthesis, 2 non conventional prosthesis of polymethacrylate with steel soul and 1 case non conventional prosthesis of polyethylene, with interchangeable head. Treatment was instituted with prophylactic antibiotic for 5 days (cefotaxime) from a previous day to the surgery. The adjuvant treatment with chemo and/or radiotherapy was instituted at the three weeks of postoperative. The age of the patients varied from 15 to 65 years, average of 30.9; the sex was masculine 15 (48.4%) and feminine 16 (51.6%); the follow-up varied from 12 to 95 months (average of 52.5%). Results. A decrease of the active mobility of the shoulder of 30 degrees was found; the function of the hand and elbow was conserved normal in all the patients, being considered in agreement with the criteria of the International Society of Musculoskeletal Tumors (9): 16 excellent cases (51.7%), good 5, regular 5 and bad 5 (16.1%) respectively. The most frequent complications were: recurrence of the tumor, paresis of the radial, and rupture of the prosthesis (in two cases, associated to traumatism). Mortality is not modified, however a better quality of life is achieved, allowing the mobility of the extremity, especially of the elbow and the hand.


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