{"title":"Is the clavicla pro humero a reliable reconstruction for paediatric proximal humerus sarcomas?","authors":"Zhuoyu Li, Daoyang Fan, Qing Zhang, Weifeng Liu","doi":"10.1007/s00264-024-06345-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The proximal humeral reconstruction is challenging. This study aims to investigate the survival, function and complications of clavicla pro humero (CPH) for pediatric proximal humeral reconstruction.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on eight patients (4 males, and 4 females) who underwent clavicla pro humero reconstruction between January 2009 and December 2020 in our institution. The average age was 10.4 ± 2.7 years (range, 6 to 14 years). The functional outcomes were assessed by the Musculoskeletal Tumor Society Score (MSTS-93), the Toronto Extremity Salvage Score (TESS), the American Shoulder and Elbow Surgeons (ASES) score and the range of motion (ROM) of the shoulder. The complications and overall survivorship of clavicla pro humero were recorded in the follow-up.</p><p><strong>Results: </strong>The mean follow-up of all patients was 54.6 ± 23.9 months (range, 24 to 84 months) and 73.3 ± 8.5 months (range, 72 to 84 months) in all survivors. All patients had a bone union at an average of 3.8 months after the initial procedure. Only one patient had no complications in the follow-up. The most common complications were clavicle fracture (87.5%, 7/8), followed by pseudarthrosis (62.5%, 5/8), proximal clavicle osteolysis (37.5%, 3/8) and skin flap necrosis (12.5%, 1/8). The average MSTS-93 score was 79% (range, 73-86%), the average TESS was 82% (range, 76-86%) and the average ASES was 70% (68-73%), respectively.</p><p><strong>Conclusions: </strong>The clavicla pro humero procedure provides rapid bone union but has a high complication rate. Therefore, we do not recommend this technique as a routine surgical procedure for paediatric proximal humeral reconstruction when other methods are available.</p><p><strong>Level of evidence: </strong>level IV therapeutic study.</p>","PeriodicalId":14450,"journal":{"name":"International Orthopaedics","volume":" ","pages":"271-278"},"PeriodicalIF":2.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00264-024-06345-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/11 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The proximal humeral reconstruction is challenging. This study aims to investigate the survival, function and complications of clavicla pro humero (CPH) for pediatric proximal humeral reconstruction.
Methods: A retrospective cohort study was conducted on eight patients (4 males, and 4 females) who underwent clavicla pro humero reconstruction between January 2009 and December 2020 in our institution. The average age was 10.4 ± 2.7 years (range, 6 to 14 years). The functional outcomes were assessed by the Musculoskeletal Tumor Society Score (MSTS-93), the Toronto Extremity Salvage Score (TESS), the American Shoulder and Elbow Surgeons (ASES) score and the range of motion (ROM) of the shoulder. The complications and overall survivorship of clavicla pro humero were recorded in the follow-up.
Results: The mean follow-up of all patients was 54.6 ± 23.9 months (range, 24 to 84 months) and 73.3 ± 8.5 months (range, 72 to 84 months) in all survivors. All patients had a bone union at an average of 3.8 months after the initial procedure. Only one patient had no complications in the follow-up. The most common complications were clavicle fracture (87.5%, 7/8), followed by pseudarthrosis (62.5%, 5/8), proximal clavicle osteolysis (37.5%, 3/8) and skin flap necrosis (12.5%, 1/8). The average MSTS-93 score was 79% (range, 73-86%), the average TESS was 82% (range, 76-86%) and the average ASES was 70% (68-73%), respectively.
Conclusions: The clavicla pro humero procedure provides rapid bone union but has a high complication rate. Therefore, we do not recommend this technique as a routine surgical procedure for paediatric proximal humeral reconstruction when other methods are available.
期刊介绍：
International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters.
Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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