European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
The lighthouse technique for humeral suspension following a modified Tikhoff-Linberg procedure for the resection of bone and soft tissue tumors around the shoulder girdle: clinical and functional outcomes.
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Samargandi Ramy, Berhouet Julien, Nicolas Quentin, Le Nail Louis-Romée
Аннотация
PURPOSE: The present study aims to describe the "Lighthouse Technique" for humeral suspension and to evaluate the clinical and functional outcomes in patients undergoing extra-articular resection for bone and soft tissue sarcoma involving the shoulder girdle.
METHODS: A retrospective study included 11 patients (4 males, 7 females) with a mean age of 47.5 years (16-82 years). These patients underwent extra-articular resection according to a modified Tikhoff-Linberg procedure followed by humeral suspension by a cement spacer "lighthouse technique" for various types of sarcomas, with 9 involving the proximal humerus and 2 involving the scapula. The dominant hand was affected in 8 patients. Two patients received preoperative and postoperative chemotherapy, and one received postoperative radiotherapy.
RESULTS: The mean follow-up duration was 42 months (2-85 months). One patient had lung metastasis at diagnosis, and another developed metastasis during the follow-up period. One patient died from septic shock two months postoperatively due to chemotherapy-related febrile neutropenia; the death was unrelated to surgery and excluded from functional analysis. There were no postoperative wound complications, infections related to surgical intervention, or reoperations. Radiographic follow-up did not reveal any modifications of the cement spacer or signs of recurrence. However, one patient reported a sensation of impingement and irritation around the axillary area. The mean Auto-Constant score was 28.5 (18-37), and the mean Musculoskeletal Tumor Society Score was 54.5 (33-66).
CONCLUSION: The lighthouse reconstruction technique for humeral suspension after tumors resection around the shoulder girdle demonstrated promising results terms of wound healing and spacer stability, suggesting its potential as a viable treatment option in selected patients.
LEVEL OF EVIDENCE IV: Retrospective study.
METHODS: A retrospective study included 11 patients (4 males, 7 females) with a mean age of 47.5 years (16-82 years). These patients underwent extra-articular resection according to a modified Tikhoff-Linberg procedure followed by humeral suspension by a cement spacer "lighthouse technique" for various types of sarcomas, with 9 involving the proximal humerus and 2 involving the scapula. The dominant hand was affected in 8 patients. Two patients received preoperative and postoperative chemotherapy, and one received postoperative radiotherapy.
RESULTS: The mean follow-up duration was 42 months (2-85 months). One patient had lung metastasis at diagnosis, and another developed metastasis during the follow-up period. One patient died from septic shock two months postoperatively due to chemotherapy-related febrile neutropenia; the death was unrelated to surgery and excluded from functional analysis. There were no postoperative wound complications, infections related to surgical intervention, or reoperations. Radiographic follow-up did not reveal any modifications of the cement spacer or signs of recurrence. However, one patient reported a sensation of impingement and irritation around the axillary area. The mean Auto-Constant score was 28.5 (18-37), and the mean Musculoskeletal Tumor Society Score was 54.5 (33-66).
CONCLUSION: The lighthouse reconstruction technique for humeral suspension after tumors resection around the shoulder girdle demonstrated promising results terms of wound healing and spacer stability, suggesting its potential as a viable treatment option in selected patients.
LEVEL OF EVIDENCE IV: Retrospective study.