The Application of Hemiarthroplasty in Elderly Patients With Proximal Humeral Metastases

This retrospective observational study reviewed patients who underwent proximal humeral hemiarthroplasty (PHH) for solitary metastatic lesions of the proximal humerus at our institution between 2013 and 2021. A total of 53 patients with histopathologically confirmed metastatic bone tumors were included in the analysis. The study population consisted of 25 males and 28 females, with ages ranging from 43 to 82 years.

Patients were divided into two groups according to age: Group A (≥65 years, n = 25) and Group B (<65 years, n = 28). All metastatic lesions were unilateral and located in the proximal one-third of the humerus without involvement of the scapula.

The most common primary malignancies included breast cancer, lung cancer, renal cell carcinoma, thyroid cancer, prostate cancer, colorectal cancer, hepatocellular carcinoma, gastric cancer, uterine cancer, and cancer of unknown primary origin. Prior resection of the primary tumor had been performed in 22 patients before presentation. Nineteen patients had comorbidities such as diabetes mellitus, hypertension, chronic gastritis, or pulmonary emphysema. Pathological fractures were present in 19 cases.

All patients underwent wide tumor excision followed by proximal humeral hemiarthroplasty using a Malawer type I resection technique. Clinical and surgical data were collected from medical records for subsequent analysis.