Evaluation of patient’s daily activities with Free Non-Vascularized Fibular Head Graft (FNVFHG) as a treatment after resection of proximal humeral tumors

Introduction: Free non-vascularized fibular head graft (FNVFHG) is a method in handling bone defect after wide resection of the tumor.Methods: This study used descriptive research with the sample of three cases of proximal humeral giant cell tumor that underwent bone resection and reconstructed with a free non-vascularized fibular head graft. The outcomes were measured by the Musculoskeletal Tumor Society (MSTS) score, range of motion of the shoulder, and activity of daily living. Results: The overall MSTS score of 3 patients was 73%. Two patients were able to perform all the shoulder motions,including flexion, extension, abduction, external rotation, internal rotation with limited range of motion, while the other patient could only perform restricted internal rotation. Two patients performed all of their daily activities with the affected extremity, including personal hygiene (tooth brushing), writing, eating, holding a glass, dressing, and riding a motorcycle.In contrast, the other patient encountered difficulty performing tooth brushing and self-feeding with the affected extremity,using the contralateral upper extremity.Conclusions: Free non-vascularized fibular head graft may serve as an option in handling bone defect after wide resection of musculoskeletal tumor at the proximal humerus. This method can be safely performed with an acceptable functional outcome.