A 19-year-old man has a high-grade osteosarcoma of the proximal humerus with an intact axillary nerve and deltoid function. Wide extra-articular resection of the scapulohumeral joint region with preservation of the hand and forearm is planned. This limb salvage procedure is known as:

• A Tikhoff-Linberg resection ✓
• B Van Nes rotationplasty
• C Syme amputation
• D Clamshell hemipelvectomy

Explanation

The Tikhoff-Linberg procedure is a type IV resection in which the proximal humerus, scapula and lateral clavicle are removed en bloc while sparing the distal arm, allowing reconstruction with a custom prosthesis or arthrodesis. Rotationplasty converts an ankle into a knee joint after femoral resection. Syme amputation is a foot-level amputation, and hemipelvectomy removes half the pelvis. Preserving a functional hand makes this shoulder girdle resection preferable to forequarter amputation.

Reference: Campbell's Operative Orthopaedics, 14th ed.

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Written and medically reviewed by the StethoPrep medical team.