Functional Augmentation with the Use of a Mesh in a Traditional Cement Spacer Reconstruction in Proximal Humerus Resections.

Abstract

Cement spacer as a reconstruction technique in proximal humerus resections in malignant and benign conditions is well established. Functional outcome of any reconstruction is decided by how well soft tissue reconstruction has been carried out. The cement spacer technique allows soft tissue reattachment at any site required as compared to prosthetic reconstruction, but such reattachment sites have to be decided before setting of the cement. Here we describe a technique in which a prolene mesh is used as a mould for the cement. The outer prolene mesh gives the surgeon the opportunity to anchor soft tissues during closure at any area desired. The mesh creates a porous surface over the stem which will aid in better healing by fibrosis for the muscle as compared to healing over smooth cement. Mesh fibrosis is another added point of stability at the bone-construct junction. Post-operative shoulder range of motion was easier to achieve in such patients.