Functional laboratory assessment after oncologic shoulder joint resections

Area of Science:

• Orthopedic Surgery
• Oncology
• Rehabilitation Medicine

Background:

• Surgical resection of shoulder tumors impacts upper extremity function.
• Reconstruction methods aim to restore shoulder range of motion and distal strength.

Purpose of the Study:

• To evaluate shoulder range of motion and distal strength post-oncologic resection and reconstruction.
• To compare functional outcomes based on surgical variables and reconstruction techniques.

Main Methods:

• Laboratory evaluation of 32 patients with proximal humerus or scapula bone tumors treated surgically (1976-1992).
• Assessment of active shoulder range of motion and isometric elbow/forearm strength.
• Comparison of outcomes between different resection (modified Tikhoff-Linberg vs. classic) and reconstruction (osteoarticular allografts vs. vascularized fibular arthrodeses) methods.

Main Results:

• Greater bony resection and deltoid removal correlated with reduced shoulder motion and strength.
• Modified Tikhoff-Linberg resection improved shoulder motion compared to classic resection, which yielded greater distal strength.
• Osteoarticular allografts offered superior motion and strength, provided rotator cuff and deltoid were reconstructible, though elbow strength declined over time.
• Vascularized fibular arthrodeses provided good range of motion (except rotation) but significantly less strength than allografts.

Conclusions:

• Surgical extent and technique significantly influence shoulder and distal upper extremity function after oncologic resection.
• Osteoarticular allografts represent a promising reconstructive option for function, but long-term outcomes require monitoring.
• Vascularized fibular arthrodesis is a viable alternative for range of motion but compromises strength.