Sarcoma / 2019 / Article / Tab 2

Clinical Study

Reconstructive Challenges of Proximal Ulnar Bone Tumors: Our Experience with Biological Osteoarticular Reconstruction Using Extracorporeal Irradiation and Reimplantation

Table 2

Comparison of outcomes of various reconstruction options reported in the literature, following proximal ulna resection for bone tumors.

Study, yearCasesReconstruction techniqueResultsComplications and remarks

Current study3Osteoarticular extracorporeal irradiation and reimplantation of proximal ulna resected segmentROM: 0° to 130°
Pronosupination: full
Power: 5/5
MSTS: 100% (30/30)
DASH: zero
MEPS: 100
Implant prominence over the elbow in 1 case
Rydholm, 1987 [3]1Radius neck to humerus trochlea articulationROM: 35° to 135°
Pronosupination: 40°
Muscle weakness nearly 50 percent of normal
Gianoutsos et al., 1994 [6]1Osteocutaneous fibular free flapROM: 10° to 100°
Pronation: 45°
Supination: 35°
Power: 4/5
Instability of the joint
Donor site: leg edema
Kimura et al., 2002 [7]1Vascularized fibular graftMSTS 100% (30/30)Annular ligament reconstructed for joint stability
Weber et al., 2003 [8]11 elbows (1 proximal ulna tumor)Total elbow replacementMean MSTS: 83% (25/30)Periprosthetic lysis
Duncan et al., 2008 [2]2Radial neck to humerus trochlea transpositionMSTS (Mean): 88.3% (26.5/30)Joint instability and muscle weakness
Guo et al., 2008 [9]19 elbows (5 proximal ulna tumors)Total elbow arthroplastyMEPS:
Good in 14/19: 77.8%
Poor in 4/19: 22.2%
Stem loosening
Periprosthetic lysis
Revision surgeries
Ogose et al., 2010 [13]1Combined vascularized fibula + osteochondral extracorporeal irradiated graft.ROM: 20° to 120°
Pronation: 80°
Supination: 10°
Proximal osteotomy site nonunion: bone grafting at 16 months after surgery
Chen et al., 2012 [4]1Radius neck to humerus trochlea transpositionMSTS: 83% (25/30)
ROM: 10° to 90°
Joint instability
Muscle strength weakness
Sewell et al., 2012 [10]4Custom proximal ulna endoprosthetic replacementMean MSTS: 90% (27/30)
Mean TESS: 81 (73 to 88)
Triceps weakness
Sulko, 2013 [5]1Radial head transposition with inverted V-plasty of tricepsMSTS: 96.67% (29/30)
DASH: zero
Power: 5/5
Restricted Pronation.
Limb length discrepancy: 2 cm
Puri et al., 2016 [1]1Medialization of radius to a preserved proximal articular segment of ulnaROM: 10° to 130°
MSTS: 90% (27/30)
Restricted pronosupination
Limb length discrepancy.
Implant prominence over elbow

ROM: range of movement. MSTS: musculoskeletal tumor society score. MEPS: Mayo elbow performance score. TESS: Toronto extremity salvage score. DASH: disability of arm, shoulder, and hand score. Muscle power as measured on the Lovett scale.

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