Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Division of Plastic and Reconstructive Surgery, Mayo Clinic, Rochester, Minnesota.
JBJS Rev. 2024 Mar 11;12(3). doi: e23.00217. eCollection 2024 Mar 1.
» The proximal humerus is a common location for primary bone tumors, and the goal of surgical care is to obtain a negative margin resection and subsequent reconstruction of the proximal humerus to allow for shoulder function.» The current evidence supports the use of reverse total shoulder arthroplasty over hemiarthroplasty when reconstructing the proximal humerus after resection of a bone sarcoma if the axillary nerve can be preserved.» There is a lack of high-quality data comparing allograft prosthetic composite (APC) with endoprosthetic reconstruction of the proximal humerus.» Reverse APC should be performed using an allograft with donor rotator cuff to allow for soft-tissue repair of the donor and host rotator cuff, leading to improvements in shoulder motion compared with an endoprosthesis.
»肱骨头是原发性骨肿瘤的常见部位,手术治疗的目标是获得阴性切缘切除,并随后重建肱骨头,以恢复肩部功能。»目前的证据支持在保留下腋神经的情况下,在骨肉瘤切除后重建肱骨头时,使用反式全肩关节置换术而不是半肩关节置换术。»在比较同种异体骨-假体复合(APC)与肱骨头内假体重建时,缺乏高质量的数据。»使用带有供体肩袖的同种异体骨进行反向 APC 手术,以允许供体和宿主肩袖的软组织修复,与假体相比,这将改善肩部运动。