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Joint Diseases and
Related Surgery
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Original Article · Open access

The functional and clinical outcomes of primary and metastatic malignancies of the elbow

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Güray Toğral

Department of Orthopedics and Traumatology, Abdurrahman Yurtaslan Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0002-2489-9335

Hüseyin Emre Tepedelenlioğlu

Department of Orthopedics and Traumatology, Ankara Etlik City Hospital, Ankara, Türkiye

ORCID: 0000-0002-3946-8554

Erkan Akgün

Department of Orthopedics and Traumatology, Ankara Etlik City Hospital, Ankara, Türkiye

ORCID: 0000-0002-7461-3526

İzzet Korkmaz

Department of Orthopedics and Traumatology, Abdurrahman Yurtaslan Training and Research Hospital, Ankara, Türkiye

ORCID: 0000-0001-7327-3809

Tolga Tolunay

Department of Orthopedics and Traumatology, Gazi University Faculty of Medicine, Ankara, Türkiye

ORCID: 0000-0003-1998-3695

Abstract

Objectives: This study aims to investigate the etiological distribution of primary and metastatic malignancies around the elbow and the effect of surgical and adjuvant treatments on clinical outcome.

Patients and methods: Between January 2006 and December 2020, medical records of a total of 33 patients with elbow neoplasm (15 males, 18 females; median age: 55 years; range, 39 to 71 years) who underwent surgical treatment and with or without clinical treatment were retrospectively analyzed. The outcomes and frequencies of the elbow metastatic and primary malignancies were evaluated. Data were collected from patients' medical and radiological documents, and a dedicated archive was created for this study.

Results: Most tumors occurred on the right side and were intra-articular or distal to the humerus. A total of 75.8% (25/33) of the patients had tumors of any diameter ≥5 cm. Most patients were treated with extensive resection. A total of 81.8% (27/33) of the patients had wide resected tumor margins, and 18.2% (6/33) had intralesional tumor margins. The median follow-up was 42 (range, 1 to 83) months. Synovial sarcoma and malignant peripheral nerve sheath tumors were the most common soft tissue sarcomas, and pulmonary adenoma and multiple myeloma were found in metastatic lesions.

Conclusion: Elbow surgery is particularly challenging due to the interrelationship of major neurovascular structures. Synovial sarcoma and malignant peripheral nerve sheath tumors are the most common soft tissue sarcomas, and pulmonary adenoma and multiple myeloma are found in metastatic lesions. Limb-sparing surgery is the gold-standard method recently.

Declarations

Ethics Committee Approval

The study protocol was approved by the Gazi University Ethics Committee (date: 05.10.2023, no: E-77082166-604.01.02-764631). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Informed Consent

A written informed consent was obtained from each patient.

Author Contributions

Idea/concept: G.T.; Design: G.T., H.E.T.; Control/supervision: T.T.; Data collection and/or processing, writing the article: H.E.T.; Analysis and/or interpretation: İ.K.; Literature review, critical review: G.T., T.T.; Materials: E.A.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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