Is it safe to preserve the deltoid when resecting the proximal humerus for a primary malignant bone tumour? A comparative study.

AIMS: Resection of the proximal humerus for the primary malignant bone tumour sometimes requires en bloc resection of the deltoid. However, there is no information in the literature which helps a surgeon decide whether to preserve the deltoid or not. The aim of this study was to determine whether retaining the deltoid at the time of resection would increase the rate of local recurrence. We also sought to identify the variables that persuade expert surgeons to choose a deltoid sparing rather than deltoid resecting procedure. PATIENTS AND METHODS: We reviewed 45 patients who had undergone resection of a primary malignant tumour of the proximal humerus. There were 29 in the deltoid sparing group and 16 in the deltoid resecting group. Imaging studies were reviewed to assess tumour extension and soft-tissue involvement. The presence of a fat rim separating the tumour from the deltoid on MRI was particularly noted. The cumulative probability of local recurrence was calculated in a competing risk scenario. RESULTS: There was no significant difference (adjusted p = 0.89) in the cumulative probability of local recurrence between the deltoid sparing (7%, 95% confidence interval (CI) 1 to 20) and the deltoid resecting group (26%, 95% CI 8 to 50). Patients were more likely to be selected for a deltoid sparing procedure if they presented with a small tumour (p = 0.0064) with less bone involvement (p = 0.032) and a continuous fat rim on MRI (p = 0.002) and if the axillary nerve could be identified (p = 0.037). CONCLUSION: A deltoid sparing procedure can provide good local control after resection of the proximal humerus for a primary malignant bone tumour. A smaller tumour, the presence of a continuous fat rim and the identification of the axillary nerve on pre-operative MRI will persuade surgeons to opt for a deltoid resecting procedure. Cite this article: Bone Joint J 2017;99-B:1244-9.

The crucial role of selenium for sulphur substitution in the structural transitions and thermoelectric properties of Cu5FeS4 bornite.

Bornite Cu5FeS4-xSex (0 ≤ x ≤ 0.6) compounds have been synthesized, using mechanical alloying, combined with spark plasma sintering (SPS). High temperature in situ neutron powder diffraction data collected on pristine Cu5FeS4 from room temperature up to 673 K show that SPS enables the stabilization of the intermediate cubic (IC) semi-ordered form (Fm3[combining macron]m, aIC ∼ 10.98 Å) at the expense of the ordered orthorhombic form (Pbca, aO ∼ 10.95 Å, bO ∼ 21.86 Å, cO ∼ 10.95 Å) in the 300-475 K temperature range, whereas above 475 K the IC form coexists with the high temperature cubic (C) form (Fm3[combining macron]m, aC ∼ 5.50 Å). The ability of Se for S substitution to induce disorder and consequently to enhance the IC phase formation is also emphasized. This disordering effect is explained by the high quenching efficiency of the SPS method compared to conventional heating. The existence of topotactic phase transformations, as well as Se for S substitution is shown to have a significant effect on the transport properties. As expected, electrical transport properties indicate a change towards a more metallic behaviour with increasing Se content. The electrical resistivity reduces from ∼21.4 mΩ cm for the pristine Cu5FeS4 to ∼3.95 mΩ cm for Cu5FeS3.4Se0.6 at room temperature. A maximum power factor of 4.9 × 10-4 W m-1 K-2 is attained at 540 K for x = 0.4 composition. The influence of selenium substitution on the carrier effective mass and mobility is discussed based on single parabolic band approximation. Furthermore, a detailed investigation of the thermal conductivity by this isovalent anion substitution reveals a significant reduction of the lattice thermal conductivity due to the alloying effect. Finally, the important role of structural transitions in the thermoelectric properties is addressed. A maximum ZT of 0.5 is attained at 540 K for Cu5FeS3.8Se0.2 composition.

Interplay of disorder and antiferromagnetism in TlFe(1.6+δ)(Se(1-x)S(x))2 probed by neutron scattering.

The effect of selenium substitution by sulphur on the structural and physical properties of antiferromagnetic TlFe1.6+δSe2 has been investigated via neutron, x-ray and electron diffraction, and transport measurements. The √5a×√5a×c super-cell related to the iron vacancy ordering found in the pure TlFe1.6Se2 selenide is also present in the S-doped TlFe1.6+δ(Se1-xSx)2 compounds. Neutron scattering experiments show the occurrence of the same long range magnetic ordering in the whole series i.e. the 'block checkerboard' antiferromagnetic structure. In particular, this is the first detailed study where the crystal structure and the √5a×√5a antiferromagnetic structure is characterized by neutron powder diffraction for the pure TlFe1.6+δS2 sulphide over a large temperature range. We demonstrate the strong correlation between occupancies of the crystallographic iron sites, the level of iron vacancy ordering and the occurrence of block antiferromagnetism in the sulphur series. Introducing S into the Se sites also increases the Fe content in TlFe1.6+δ(Se1-xSx)2 which in turn leads to the disappearance of the Fe vacancy ordering at x = 0.5 ± 0.15. However, by reducing the nominal Fe content, the same √5a×√5a×c vacancy ordering and antiferromagnetic order can be recovered also in the pure TlFe1.6+δS2 sulphide with a simultaneous reduction in the Néel temperature from 435 K in the selenide TlFe1.75Se2 to 330 K in the sulphide TlFe1.5S2. The magnetic moment remains high at low temperature throughout the full substitution range, which contributes to the absence of superconductivity in these compounds.