Total elbow arthroplasty after resection of tumors at the elbow / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the effects and complications of the total elbow arthroplasty after the resection of the peri-elbow tumor.</p><p><b>METHODS</b>Between June 1998 to June 2007, 19 patients underwent total elbow arthroplasty after resection of tumors at the authors department, which involved 13 males and 6 females, including 6 patients with metastatic tumor, 1 with giant cell tumor of bone (GCT), 2 with malignant fibrous histiocytoma (MFH), 4 with osteosarcoma, 3 with Ewing sarcoma, l with lymphoma, 1 with synovial sarcoma, and 1 with desmoid fibroma of the bone. The age of patients ranged from 15 to 71 years (mean 43 years).</p><p><b>LOCATION</b>distal humerus in 9 cases, proximal ulna in 5 and the tumor involving both distal humerus and proximal ulna in 5 patients.</p><p><b>RESULTS</b>Patients were evaluated according to the Mayo Elbow Performance Score. Pain scores decreased from a mean of 3.6 to 2.0. Mean arc of elbow motion from extention to flexion improved from 30 to 80 (range, 55 - 105). Fourteen elbows had excellent or good result (14/19, 77.8%), and 4 elbows had a poor result (22.2%). There was no wound infection or other complication after surgery. During the following up time, 2 patients with metastatic lung cancer, 1 with metastatic rectal cancer and 1 with ovarian cancer died in 2 years after surgery. Two Ewing sarcoma, 1 MFH and 1 osteosarcoma patients occurred lung metastasis (4/18, 22.2%), and two patients had local recurrence (11.1%). Three patients occurred complication during the following time (3/18, 16.7%), the stem of humerus prosthesis came out of channel in 1 case 5 years after surgery, the stem of ulna prosthesis came out of channel in 1 case 4 years after surgery, and both cases did revision surgery. The stem loosening was in 1 humerus prosthesis 4 years after surgery.</p><p><b>CONCLUSIONS</b>The results show that total elbow arthroplasty after resection of tumors can decrease the pain, and improve the function substantially. For metastatic tumors, this technique also can be used if there is no other good option.</p>