DOI: https://doi.org/10.22141/1608-1706.6.18.2017.121177

Surgical treatment of tumors of the proximal humerus (literature review)

O.Ye. Vyrva, D.O. Mikhanovskiy

Abstract


Tumors of the proximal humerus (TPH) are the most frequent lesion localization among the bones of the upper limb and the third after the segments forming the knee joint and the proximal femur. Osteosarcoma, chondrosarcoma, malignant fibrous histiocytoma and metastatic lesions most often affect this area and require surgical intervention. To date, a number of methods have been developed for the treatment of TPH, including exarticulation, humeroscapular amputation, marginal and parietal resection, wide resection of TPH. Considering that the upper limb is a working organ and its loss leads to persistent disability of the patient and severe psycho-emotional problems, the main method for surgical treatment of tumors requiring complete removal is a wide resection of the TPH with replacement of the implant for the maximum possible restoration of the function of the shoulder joint. This article presents the main classifications of tumors and degrees of their prevalence, resorting to which, a treatment plan is being developed, as well as methods for the diagnosis and treatment of TPH, which, among others, include a wide resection of the affected segment. Replacement of postresection defects is currently performed mainly by bone grafts or with the help of endoprostheses. Bone grafts can replace large defects, however, for the wide use of this technique, large bone banks are required to select an implant for anatomical replacement of the defect. There are also a number of complications in this type of treatment, the most common of which (75 % of cases) is lysis of the graft, especially when conducting chemotherapy in the postoperative period. Endoprosthetics helps to avoid most of the complications during bone plasty, allows to replace anatomically the resection defects of any size, to carry out rehabilitation and recovery treatment in the early postoperative period and to maximize the function of the affected segment.

Keywords


proximal humerus; tumor; replacement of defects; endoprosthetics

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