Proximal humeral reconstruction after excision of a primary sarcoma

From 1978 to 1991, 19 patients underwent wide resection of the proximal humerus for a primary bone tumor. Reconstructions included intercalary autoclaved autograft and Neer prosthesis composites in 11 patients, intercalary allograft and Neer prosthesis composites in 4 patients, and a Neer prosthesis with methylmethacrylate in 4 patients. All patients were observed for at least 2 years or until death. The functional results and complications of the 19 procedures were evaluated. Function was rated as excellent for 17 patients and good for 2 patients. There were no failures of fixation. Local recurrence occurred in 2 patients. There were 2 cases of recurrent anterior subluxation and 1 of dislocation. Two superficial wound infections were treated successfully with local debridement and antibiotics. The authors conclude that autoclaved autograft or allograft when combined with a long-stem cemented Neer prosthesis offers an excellent composite for proximal humeral reconstruction.