2002 CTOS Annual Meeting Oral Presentations — Surgery

ENDOPROSTHETIC REPLACEMENT OF DISTAL HUMERUS AFTER TUMOR RESECTION
[Abstract ID: 74]

Category: Surgery

Presentation: Oral

Authors: Ashwin Kulkarni¹, Fabrice Fiorenza¹, Rob J Grimer¹, Abesegun Abudu¹, Simon R Carter¹, Roger M Tillman¹

Author Institutions: ¹The Royal Orthopaedic Hospital Birmingham, United Kingdom

Presenter: Fabrice Fiorenza
Fabrice.Fiorenza@chu-limoges.fr

Correspondent: Rob J Grimer
rob.grimer@btopenworld.com
Birmingham United Kingdom B31 2AP
Ph: 44 1216854000
Fax: 44 1216854146

Objectives: The purpose of this study was to determine the outcome of patients after distal humerus reconstruction for bone tumors using endoprosthetic replacement (EPR).

Methods: 10 patients were retrospectively reviewed after resection of a primary or metastatic tumor of the distal humerus between 1970 and 2001.They all had a custom made distal humerus EPR. No patients was lost to follow up. The Toronto Extremity Salvage score (TESS) was used to assess function in patients still alive.

Results: There were 4 male and 6 female patients, with ages ranging from 15 to 76 years. The period of follow up ranged from 5 months to 31 years. 8 patients had primary tumors and 2 had secondary tumors. 4 out of 10 patients developed metastasis and died 12 to 71 months after the operation. None of the 10 patients had local recurrence, infection, amputation or permanent nerve palsy. Average flexion deformity was 15 degrees (0-35) and average flexion of these patients was 115 degrees (110 – 135). There were 3 revisions at 48, 56 and 366 months for aseptic loosening. There were 3 rebushings of the plastic inserts at 62,78 and 113 months. Two of the three rebushings were done after revision of the humeral component at 6 months and 30 months. The average TESS score for these patients was 72.91 (29.2 to 93.33).

Conclusions: Custom made EPR for distal humeral tumors are an effective way of replacing the diseased bone leading to a reasonable level of function and an acceptable failure rate.