Abstract
INTRODUCTION
Elbow joint is a rare site of involvement for primary and metastatic bone tumors. Surgery involving this area should be done carefully because of the vascular structures and nerve related with the region. We aimed to evaluate the outcome of patients who were reconstructed with a modular endoprosthesis involving the elbow joint and distal humerus due to tumor resection and other causes.
METHODS
We retrospectively reviewed the demographics, tumor prothesis etiology, tumor characteristics and functional plaster of 12 patients who underwent resection with oncologic and non-oncological reasons for the elbow joint and reconstruction with modular megaprosthesis between 2005-2016 in our clinic.
RESULTS
Twelve cases were included in the study, with a mean age of 53 (18-75) years. Seven of the patients were male. The mean follow-up period was 33 months (4-120 months). Elbow reconstruction was performed due to bone tumor resection in 10 patients(7 patients metastatic, 3 patients primer) while following previous unsuccessful elbow prosthesis in 2 patients. The mean Musculoskeletal Tumor Society (MSTS) score was 77 (67-93) while the mean Mayo Elbow Performance Score (MEPS) score was 63 (45-80). The preoperative visual analog scale (VAS) score of the patients was 7 (6-9), whereas these values were reduced to 5 (4-6) postoperatively. Complications were observed in 4 cases: transient radial palsy in 1, superficial wound infection in 1 and periprostatic fracture in ulnar component in 2 patients.
DISCUSSION AND CONCLUSION
In patients who have applied modular megaprosthesis to the elbow joint, a painless elbow, forearm and wrist joint are obtained at a high rate and the patient begins to use the extremity shortly after the operation. Furthermore, an aggressive resection ensuring that adequate surgical margin is achieved; provides a potential cure for primary local aggressive tumors, although for metastatic tumors it provides satisfactory functional result but do not contribute much to the total life expectancy.