CASE REPORT

 

Proximal humeral allograft in a trauma setting

 

 

R Bhaga^I; AA Aden^II

^IMBBCh; Registrar. Department of Orthopaedics, University of Witwatersrand, Helen Joseph Hospital, Johannesburg, South Africa
^IIFCS(SA)Orth; Senior Consultant. Department of Orthopaedics, University of Witwatersrand, Helen Joseph Hospital, Johannesburg, South Africa

Correspondence

 

 

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ABSTRACT

Proximal humeral allografts are usually reserved for reconstruction of the shoulder in a neoplastic setting.
To our knowledge it has never been described for use in a trauma setting.
In this case report, we present a 30-year-old man involved in a motor vehicle accident (MVA) in 2007. He is right-hand dominant and employed as a driver. He presented initially to a peripheral hospital, and he sustained what seems to be a right floating shoulder injury with clavicle, scapula and proximal humeral fractures. He was operated there and underwent excision of the proximal humerus.
Subsequently he presented to us and a staged procedure was performed. Initially, the clavicle was plated and, six weeks later, he underwent reconstruction with a proximal humeral allograft. All rotator cuff muscles were re-attached and the allograft was secured with cement and an intramedullary nail.
We present his pre-op and post-op pictures as well as the function achieved. We also present a brief review of the literature.

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References

1. Gebhardt MC, Roth YF, Mankin HJ. Osteoarticular allografts for reconstruction in the proximal part of the humerus after excision of a musculoskeletal tumor. J Bone Joint Surg Am 1990;72:334-45.         [ Links ]

2. Rödel RW, Gosheger G, Gebert C, Lindner N, Ozaki T, Winkelmann W. Reconstruction of the proximal humerus after wide resection of tumours. J Bone Joint Surg Br 2002:84-B:1004-8.         [ Links ]

3. O'Connor MI, Sim FH, Chao EYS. Limb salvage for neoplasms of the shoulder girdle - Intermediate reconstructive and functional results. J Bone Joint Surg Am December 1996;78-A(12):1872-88.         [ Links ]

4. Borjian A, Nazem K, Yassine H. Complications of massive allografts reconstruction for bone tumors. J Research in Medical Sciences July & Aug 2006;.11(4):240-7.         [ Links ]

5. Getty P, Peabody T. Complications and functional outcomes of reconstruction with an osteoarticular allograft after intra-articular resection of the proximal aspect of the humerus. J Bone Joint Surg Am August 1999;81-A(8):1138-46.         [ Links ]

 

 

Correspondence:
Dr R Bhaga
PO Box 324
Extension 1
1820 Lenasia
Cell: 072 242 5644
Email: ravibhaga@hotmail.com