The most common bone tumors of the upper extremity in childhood and adolescence and their treatment: a review of the current literature

In upper extremity bone tumors, osteochondromas and solitary bone cysts represent the predominant benign entities, with osteosarcoma accounting for the majority of malignant presentations. The proximal humeral metaphysis emerges as the most prevalent anatomical site across both tumor entities. Upper, one-sided extremity pain in children and adolescents should be followed up and diagnosed, since 'growing pain' in the upper extremities is not a common finding. Osteochondromas should be surgically addressed early if they impose a risk of development of a deformity, such as those located on the forearm and the distal tibia, where they can cause growth disorders and thus functional impairments. Reconstructions for pediatric malignant bone tumors of the upper arm or forearm should allow the spatial placement of the hand. Given the longevity of sarcoma survivors, the longevity of the reconstruction is an important planning consideration. Biological reconstructions combining autologous/vascularized bone with tendon repair and transfers appear to be the most appropriate and preferable to prosthesis whenever possible. Multidisciplinary collaboration involving plastic surgeons with hand reconstruction expertise constitutes a critical component in orthopedic oncology treatment planning.