上腕骨近位骨肉腫に対して pedicle freezing method を使用した 1 例

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Endoprosthetic replacement of the shoulder after resection of the tumor can provide good results, but there are problems about loosening and fracture around the stem. We report the use of pedicle freezing method for an osteosarcoma of the proximal humerus.<BR>A fifteen year-old man suffered from a metastatic osteosarcoma of the proximal humerus. The primary tumor occurred in his left fibula 6years previously, and he had undergone operations three times; left femoral amputation, right knee arthroplasty and left femoral hemi-arthroplasty. We performed an operation without using prosthesis, because we were afraid of loosening of the stem and fracture around the implant because of his large body (height 172cm, weight 87kg, BMI 29.4). We selected tumor resection and reconstruction using pedicle freezing method. The proximal humerus was exposed from head to proximal 2/3 after separating the muscles and tendons, and we soaked it in liquid nitrogen. After freezing, we reconstructed muscles and tendons with sutures.<BR>His shoulder range of motion was 60 degrees in elevation, 45 degrees in abduction at the last follow-up. His shoulder range of motion was restricted, however he could go to high school by himself.<BR>Pedicle freezing method has a merit of preservation of the patients own bone, but a demerit of degenerative formation of cartilage. In this case the patient had a limitation of shoulder function, but had no recurrence. Long-term follow-up may be mandatory to detect the occurrence of secondary osteoarthritis of the shoulder.

上腕骨近位骨肉腫に対して pedicle freezing method を使用した 1 例

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