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Bones of the Upper Limb: Humerus

Bones of the Upper Limb: Humerus

The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...

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Reverse Total Shoulder Arthroplasty

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Published on: July 5, 2011

Outcomes of Oncologic Total Humeral Reconstruction.

Leilani Garayua-Cruz¹, Samuel E Broida², Mikaela H Sullivan²

¹University of Puerto Rico School of Medicine, San Juan, Puerto Rico.

Anticancer Research

|March 4, 2025

Summary

Total humerus reconstruction for malignant tumors is a rare procedure with a high complication rate. While limb salvage is possible, functional outcomes are often poor, with significant 5-year failure and survival rates.

Keywords:

Total humerus allograft prosthetic composite endoprosthesis upper extremity

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The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

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Published on: September 7, 2022

Area of Science:

Orthopedic oncology
Surgical reconstruction
Limb salvage surgery

Background:

The humerus is the most frequent upper extremity site for malignant tumors.
Total humeral resection with shoulder and elbow replacement is a rare but sometimes necessary procedure.
Evaluating outcomes of total humeral reconstruction is crucial for limb salvage in complex cases.

Purpose of the Study:

To assess the outcomes of total humeral reconstruction at our institution.
To analyze complication rates and functional results following this extensive surgery.
To determine the efficacy of limb salvage in patients with limited treatment options.

Main Methods:

A retrospective study included nine patients (5 female, 4 male, mean age 48±26 years) with malignant humeral tumors.
Surgical reconstruction involved either endoprostheses (n=5) or allograft prosthetic composites (n=4).
Outcomes were evaluated based on complications, revision rates, survival, and functional scores.

Main Results:

Eight out of nine patients experienced postoperative complications, including deep vein thrombosis (DVT) and elbow contractures.
The cumulative incidence of failure was 25% at 5 years, with a 5-year overall patient survival rate of 13%.
The median Musculoskeletal Tumor Society (MSTS) Score at follow-up was 50%, indicating limited functional recovery.

Conclusions:

Total humerus reconstruction is associated with a high complication rate and suboptimal functional outcomes.
Despite poor results, this procedure offers a limb salvage option for patients with few alternatives.
Further research may be needed to improve outcomes for this challenging surgical intervention.