[Replacement of invert-type artificial total scapula and shoulder joint prosthesis for malignant tumor].

OBJECTIVE: To estimate the clinical curative effect of replacement of invert-type artificial total scapula and shoulder joint prosthesis and reserving arm with rehabilitation of function in the treatment of.malignant tumor in shoulder.

METHODS: From February 2001 and November 2004, five youth patients with primary malignant shoulder tumors were treated operatively by resection of neoplasms thoroughly, replacement of invert-type artificial total shoulder blade and joint prosthesis, the functional reconstruction. Of them, there were 4 males and 1 female, aging from 19 to 26 years with an average of 23.6 years. Two cases were diagnosed as having osteosarcoma, one as having chondrosarcoma, and 2 as having Ewing sarcoma. After operation, the upper limbs was immobilized for 3 weeks. The rehabilitation training including passive exercise and initiative exercise.

RESULTS: The average operative time was 425 min (380 to 530 min), and the blood loss ranged from 1250 ml to 1900 ml (1540 ml on average). The follow-up ranged from 7 to 52 months, with an average of 24.6 months. Postoperative complication included 1 case of pneumothorax, one case of shoulder incision skin part necrosis and 1 case of clavicle stump raising and pierce skin with shallow infection. No complication of postoperative incision deeply infection, nerve damage and prosthesis exposure or dislocation occurred. According to the scoring system of JOA (Japan orthopaedics association), the average score was 65 (60 to 72). The flexion and extension function of elbow joint recovered to normal.

CONCLUSION: The replacement of invert-type artificial total scapula and shoulder joint prosthesis is an efficacious method for the treatment of malignant tumor in shoulder. There are advantages of numerous adaption, wide range of motion and good stability. It can not only reserve arm but also rehabilitate function.