caa a22 4500 445334088 CHVBK 20180317142747.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1245/s10434-010-1443-z doi (NATIONALLICENCE)springer-10.1245/s10434-010-1443-z Functional Outcome of Arthrodesis with a Vascularized Fibular Graft and a Rotational Latissimus Dorsi Flap After Proximal Humerus Sarcoma Resection [Elektronische Daten] [Jin Wang, Jingnan Shen, Ian Dickinson] Background: The prognosis of humeral sarcomas has improved greatly in the past 20years. As a result, the challenges for orthopedic oncologists include long-term handicap and local morbidity. Methods: Shoulder reconstruction after the resection of sarcomas with the proximal humerus was evaluated for 55 patients from 1990 to 2007 at two universities. After S34(5)B resections (intra-articular resection of the proximal humerus and the abductor mechanism), the shoulders were reconstructed with arthrodesis, prosthesis, or allograft-prosthesis composites (APC). Results: At the time of the latest follow-up examination, the average duration of follow-up was 86.73months for the 39 patients who were still alive and whose limbs were salvaged. The local recurrence rate was 7.27% (4 of 55). Functional evaluation was conducted on the 39 patients who had the postreconstructions: 12 arthrodeses, 17 prostheses, and 10 APC. Statistical analysis showed that the functional score of shoulder reconstruction significantly varied among the three groups by the test of homogeneity of variances with P=0.222, by analysis of variance with P<0.01, and by post hoc test (Student-Newman-Keuls) with α=0.05. Primary arthrodesis resulted in better function and increased strength than the prostheses and the APC. Insertion of an allograft, a vascularized fibular graft, a rotational latissimus dorsi flap, and cancellous autograft bone were the preferred arthrodesis techniques used to achieve fusion and reduce complications. Conclusions: After resection of the sarcoma with the proximal humerus with the abductor apparatus, shoulder arthrodesis is recommended above other reconstructions for better functional outcome as well as increased strength and capacity to position the hand. Society of Surgical Oncology, 2011 Wang Jin Muskulaskeletal Oncology Department, First Affiliated Hospital of Zhongshan University, Guangzhou, Guangdong, China aut Shen Jingnan Muskulaskeletal Oncology Department, First Affiliated Hospital of Zhongshan University, Guangzhou, Guangdong, China aut Dickinson Ian The Wesley Hospital, The Princess Alexandra Hospital, Wesley Medical Centre, Auchenflower, Australia aut Annals of Surgical Oncology Springer-Verlag 18/7(2011-07-01), 1852-1859 1068-9265 18:7<1852 2011 18 10434 https://doi.org/10.1245/s10434-010-1443-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1443-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wang Jin Muskulaskeletal Oncology Department, First Affiliated Hospital of Zhongshan University, Guangzhou, Guangdong, China aut NATIONALLICENCE 700 1- Shen Jingnan Muskulaskeletal Oncology Department, First Affiliated Hospital of Zhongshan University, Guangzhou, Guangdong, China aut NATIONALLICENCE 700 1- Dickinson Ian The Wesley Hospital, The Princess Alexandra Hospital, Wesley Medical Centre, Auchenflower, Australia aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/7(2011-07-01), 1852-1859 1068-9265 18:7<1852 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer