Endoprosthetic replacement of the humerus combined with trapezius and latissimus dorsi transfer: a report of three patients

Introduction To improve the functional out come after proximal and/or total humerus replacement. we combined the surgical procedures described by Bateman and Gerber. Materials and methods In three patients after wide tumor resection, endoprosthetic replacement with a modular tumor endoprosthesis (MUTARS System) was performed. In addition to a capsular and muscular reconstruction using the Trevira tube, a trapezius transfer onto the Trevira tube in combination with a latissimus dorsi transfer onto the Trevira tube was performed. The patients were immobilized for 6 weeks after surgery with an abductor cast. Results After a follow-up of I year, there was no significant improvement of the shoulder function in comparison with patients who did not undergo the combined muscle transfer (control group n = 16: mean abduction 37.5 degrees; mean anteversion 35.0 degrees,- mean internal rotation 15.2 degrees,- mean external rotation 25.2 degrees). Conclusion In our patients, the combination of the Gerber and the Bateman procedures did not improve the shoulder function in patients with proximal and/or total humerus replacements. Therefore, the functional results do not justify two separate approaches and a prolonged operation time.