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05:37
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Published on: August 6, 2019
[The tikhoff-linberg procedure.].
1Ortopedická klinika IPVZ, FN Na Bulovce, Praha.
Summary
The Tikhoff-Linberg procedure offers a limb-sparing alternative for extensive shoulder tumors, involving resection of the humerus, scapula, and clavicle. While oncologically successful in most cases, long-term survival is limited by tumor extent and delayed diagnosis, despite functional preservation of the arm.
Area of Science:
- Orthopedic Surgery
- Surgical Oncology
- Musculoskeletal Oncology
Context:
- Extensive bone and soft tissue tumors in the shoulder region pose significant treatment challenges.
- Interscapulothoracic amputation is a radical option, necessitating limb-sparing alternatives.
- The Tikhoff-Linberg procedure is one such limb-saving surgical approach.
Purpose:
- To evaluate the efficacy and outcomes of the Tikhoff-Linberg procedure for treating extensive shoulder region tumors.
- To analyze oncological radicality, survival rates, and complications associated with this procedure.
- To assess the functional impact on patients undergoing this extensive limb-sparing surgery.
Summary:
- The Tikhoff-Linberg procedure, involving proximal humerus resection, total scapulectomy, and clavicle excision, was performed on eight patients over 26 years for various malignant shoulder tumors.
- Oncological goals were met in most patients, with only one local recurrence. However, long-term survival was poor (3/8 patients), attributed to tumor size and diagnostic delays.
- Complications included wound healing issues, venous thrombosis, and infection requiring endoprosthesis removal. Significant functional impairment occurred, but distal limb function was preserved, allowing some patients to return to work.
Impact:
- The Tikhoff-Linberg procedure provides a viable limb-sparing option for extensive shoulder tumors, avoiding amputation.
- Despite functional preservation of the elbow, forearm, and hand, substantial shoulder and arm impairment results.
- Improved patient selection and timely diagnosis are crucial for enhancing long-term survival outcomes in this challenging oncological procedure.
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