Limb Sparing Resection for Tumors Involving the Distal Humerus and Reconstruction with a Modular Endoprosthesis.

Tumors involving the distal humerus are extremely rare. Those tumors can be safely resected and then the extremity reconstructed. In this article, we present a series of patients treated with hinged semiconstrained modular distal humeral replacement for reconstruction following wide resection of tumors of the distal humerus. We retrospectively reviewed the charts of nine patients treated for tumors of the distal humerus between 2002 and 2013. The diagnoses consisted of three primaries, five metastatic, and one benign aggressive tumor. There were four male and five female patients ranging in age from 36 to 78 years old. Patients were followed for an average of 34 months (3 to 75 months). The functional status was rated using the Musculoskeletal Tumor Score System (MSTS). Five of the nine cases presented as a pathologic fracture. Six of the nine patients died of their diseases at a mean of 17 months after main surgery. Three patients were alive and disease-free at a mean follow-up of 69 months (63 to 75 months). Seven patients demonstrated significant improvement in their elbow pain after the endoprosthetic surgery. The MSTS score for the nine cases was 81% (63% to 97%). Tumors of the distal humerus can be safely resected through an anterior approach. Once the tumor is resected, the resultant defect is reconstructed with a modular semiconstrained prosthesis. This technique allows safe tumor resection with a low complication rate and good functional results.