Proximal ulna endoprosthetic replacement for bone tumours in young patients

The optimal reconstructive method after resection of malignant bone tumours of the proximal ulna is unknown. We report the outcome of endoprosthetic replacement in a young patient population. This was a retrospective review of four patients [three males and one female; mean age 17.5 (range 11-31) years] who underwent limb salvage with a proximal ulnar endoprosthetic replacement following excision of malignant bone tumour. Mean follow-up was 85 (range 14-194) months. All patients were alive at final follow-up and reported an improvement in pain. One patient required transhumeral amputation for intralesional excision complicating a local recurrence at one month. Two patients developed fixed flexion deformities of the elbow, one of whom required radial-head excision. Mean Musculoskeletal Tumour Society (MSTS) score and Toronto Extremity Salvage Score (TESS) were 27 (range 25-28) and 81 (73-88), respectively. Custom-made proximal ulna endoprosthetic replacement following resection of malignant bone tumours in young patients provides a stable reconstruction option with satisfactory function and without apparent compromise in patient survival.