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Proximal Humerus Resection for Parosteal Osteosarcoma

January 01, 2012

Contributors: Camilo E Villalobos, MD; James C Wittig, MD; Yvette Ho, MD; Yvette Ho, MD

Keywords: Bony Procedure

Peer review has expired on this program. It is the viewer’s responsibility to determine the educational value of this historical content.
Peer review has expired on this program. It is the viewer’s responsibility to determine the educational value of this historical content.

This video details the surgical technique for an intraarticular proximal humerus resection and endoprosthetic reconstruction for parosteal osteosarcoma. We review the patient's preoperative imaging and discuss indications for the procedure. We also illustrate the surgical steps using the extended deltopectoral approach. The surgical steps are as follows: We release the pectoralis major from the humerus and the short head of the biceps and coracobrachialis from the coracoid. Then we expose the brachial plexus and mobilize the vessels from the tumor. We incise the rotator cuff and perform a humeral osteotomy with a 2-cm margin distal to the tumor. After assembling and inserting the prosthesis, we reconstruct the joint capsule with an aortic graft and muscle transfers for soft-tissue coverage. In the video, we also discuss postoperative treatment.

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