We used custom mega-prostheses in 57 patients with aggressive benign and malignant tumours of the proximal humerus. The most common tumour was osteosarcoma, followed by giant cell tumour and chondrosarcoma. We achieved extra-articular and wide resection margins in all primary malignant tumours and narrow margins in benign and metastatic tumours. Six patients died of disease, 4 patients developed local recurrences and 43 were continuously disease free at an average follow-up of 5.5 years (range 2-14.5 years). Five patients required revision replacements. The most common complications were proximal subluxation and aseptic loosening. Functional outcome was satisfactory in 78% of cases.

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We analysed 133 patients treated with resection and endoprosthetic proximal tibial replacement from 1988 to 2000. Mean age was 22.3 years and osteosarcoma was the most common tumour. Average follow-up was 59.4 months. An excellent functional result was achieved in 63 patients and a good result in 36. The number of patients who had no evidence of disease was 102. Twenty-four patients died due to disease. Infection was the most common complication, followed by periprosthetic fracture and aseptic loosening. The 5-year limb survival rate was 85.5%.Résumé Nous avons analysé 133 malades, traités par ré-section et remplacement endoprothétique du tibia proximal de 1988 à 2000. L'âge moyen était 22.3 ans et l'ostéosarcome était la tumeur la plus fréquente. Le délai moyen de suivi était 59.4 mois. Un excellent résultat fonctionnel a été obtenu pour 63 malades et un bon ré-sultat pour 36. Le nombre de malades qui n'avaient pas de signe de maladie était 102. Vingt-quatre malades sont morts à cause de la maladie. L'infection était la complication la plus fréquente, suivi par les fractures péripro-thétiques et le descellement aseptique. La présence du membre à 5 ans était de 85.5%.