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En bloc resection and intercalary prosthesis implantation for the treatment of humeral diaphyseal bone metastases

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Abstract

Purpose

To evaluate the short-term clinical efficacy and complications of en bloc resection and intercalary prosthesis implantation for the treatment of humeral diaphyseal bone metastases.

Methods

A total of 21 patients with humeral diaphyseal bone metastases treated with en bloc resection and intercalary prosthesis implantation from August 2014 to August 2019 were retrospectively analysed. The visual analogue scale (VAS), Musculoskeletal Tumour Society (MSTS) scale, International Society of Limb Salvage (ISOLS) scoring system, Karnofsky Performance Status (KPS) scale, and Nottingham Health Profile (NHP) scale were used to assess pain, limb function, and quality of life. Survival of the patients was analysed using the Kaplan-Meier method.

Results

The patients were followed up for 12–57 months (mean: 22 months); the operative time was 68–114 minutes (mean: 76.24 min); the osteotomy length was 6.5–10 cm (mean: 8.02 cm); and the intra-operative blood loss was 95–125 ml (mean: 104.71 ml). At three, six and 12 months after surgery, the VAS and NHP scores were lower, whereas the MSTS, ISOLS, and KPS scores were higher than those before surgery, and the differences were statistically significant (P < 0.05). The survival time was four to 24 months (mean: 19.46 months). Thesix month and one year survival rates were 80.95% and 52.38%, respectively. During the follow-up period, no complications occurred except for aseptic prosthesis loosening in one patient.

Conclusions

En bloc resection and intercalary prosthesis implantation can reduce pain, improve limb function, prolong survival time, and improve quality of life in patients with humeral diaphyseal bone metastases.

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Acknowledgements

We thank Editage for providing high-quality editing services.

Funding

The present study was supported by The National Natural Science Foundation of China (grant no. 81904231), the China Postdoctoral Science Foundation (grant no. 2020M672369), and the Postdoctoral Innovation Practice Post in Hubei Province (grant no. 34).

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Authors and Affiliations

  1. Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei, People’s Republic of China

    Feifei Pu, Zhicai Zhang, Baichuan Wang, Jianxiang Liu & Zengwu Shao

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  1. Feifei Pu
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  2. Zhicai Zhang
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  3. Baichuan Wang
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  4. Jianxiang Liu
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Contributions

Feifei Pu and Zhicai Zhang performed the study and wrote the manuscript. Feifei Pu and Zhicai Zhang made substantial contributions to conception and design of the study. Baichuan Wang and Jianxiang Liu were responsible for the design of the study. Jianxiang Liu and Zengwu Shao analysed the study data. Baichuan Wang and Zengwu Shao assisted with the statistical analysis. Jianxiang and Zengwu Shao critically revised the manuscript, provided final approval of the version to be published, and made substantial contributions to conception and design. All authors read and approved the final manuscript.

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Correspondence to Jianxiang Liu or Zengwu Shao.

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This study was approved by the institutional review board of our hospital.

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Pu, F., Zhang, Z., Wang, B. et al. En bloc resection and intercalary prosthesis implantation for the treatment of humeral diaphyseal bone metastases. International Orthopaedics (SICOT) 45, 281–288 (2021). https://doi.org/10.1007/s00264-020-04845-x

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