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Related Experiment Videos

Functional laboratory assessment after oncologic shoulder joint resections

T A Damron1, M G Rock, M I O'Connor

  • 1Department of Orthopedic Surgery, Mayo Clinic, Mayo Foundation, Rochester, MN, USA.

Clinical Orthopaedics and Related Research
|April 29, 1998
PubMed
Summary
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Shoulder range of motion and distal strength decrease after oncologic resection. Modified Tikhoff-Linberg resection offers better motion, while classic resection yields greater strength. Osteoarticular allografts provide the best overall function.

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.

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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.