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Endoprosthetic replacement of the humerus combined with trapezius and latissimus dorsi transfer: a report of three patients.

Gosheger G, Hardes J, Ahrens H, Gebert C, Winkelmann W

Department of Orthopaedics, Westfaelische Wilhelms-Universitaet Muenster, Albert-Schweitzer-Strasse 33, 48149, Münster, Germany. goshegg@uni-muenster.de

INTRODUCTION: To improve the functional outcome after proximal and/or total humerus replacement, we combined the surgical procedures described by Bateman and Gerber. MATERIALS AND METHODS: In three patients after wide tumor resection, endoprosthetic replacement with a modular tumor endoprosthesis (MUTARS System) was performed. In addition to a capsular and muscular reconstruction using the Trevira tube, a trapezius transfer onto the Trevira tube in combination with a latissimus dorsi transfer onto the Trevira tube was performed. The patients were immobilized for 6 weeks after surgery with an abductor cast. RESULTS: After a follow-up of 1 year, there was no significant improvement of the shoulder function in comparison with patients who did not undergo the combined muscle transfer (control group n=16: mean abduction 37.5 degrees ; mean anteversion 35.0 degrees ; mean internal rotation 15.2 degrees ; mean external rotation 25.2 degrees ). CONCLUSION: In our patients, the combination of the Gerber and the Bateman procedures did not improve the shoulder function in patients with proximal and/or total humerus replacements. Therefore, the functional results do not justify two separate approaches and a prolonged operation time.

Published 21 February 2005 in Arch Orthop Trauma Surg, 125(1): 62-5.
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