一、肩部保肢手术肱骨近端是骨肉瘤、转移性肿瘤的多发位置,过去常以截肢治疗肱骨近端原发性恶性肿瘤,只对低度恶性肉瘤行保肢手术[1-4]。1977年Marcove等[5]报道保肢手术与截肢的疗效类似。此后,四肢原发恶性或良性侵袭性骨病变一般均采用保肢手术治疗,并发现保肢手术对患者生存率没有不良影响[3,4,6]。外科治疗肿瘤的各种方法的原则均相同:在手术时,必须获得足够大范围的肿瘤切除。理想情况下应保留主要的神经血 First, the shoulder salvage Surgery proximal humerus is osteosarcoma, multiple sites of metastatic tumors, the past often used to treat proximal humerus amputation of primary malignant tumors, low-grade malignant sarcoma only limb salvage surgery [1-4] . In 1977 Marcove et al [5] reported limb salvage surgery and amputation similar efficacy. Since then, limbs with primary malignant or benign aggressive bone lesions are generally treated with limb salvage surgery, and found limb salvage surgery has no adverse impact on patient survival [3,4,6]. The principles of the various methods of surgical treatment of tumors are the same: at the time of surgery, a large enough tumor resection has to be achieved. Ideally, the main blood should be retained