The functional and oncological results after scapulectomy for scapular tumours: 2–16-year results

Twenty-five patients underwent scapulectomy for various tumours between 1989 and 2005. We describe 23 patients with scapular tumours who were followed-up for a minimum of 2 years after scapulectomy. The average age was 29 years, and two-thirds of the patients were male. Nineteen patients had malignant neoplasms, of which chondrosarcoma was most common, followed by Ewing’s sarcoma. Surgical staging was by Enneking’s system, with stage IIB being the most frequent. Fifteen patients underwent total scapulectomy, and the rest had their glenoid retained. With an average follow-up period of 66.7 months (23–202 months), functional and oncological outcomes were evaluated for all patients. Two patients had superficial wound infections requiring antibiotics, and one had skin necrosis requiring skin cover. Functional outcome was satisfactory in 13 patients. Cosmetically and emotionally acceptable surgery, scapulectomy made 19 patients continuously disease free, while four patients died of disease. The 5-year survival rate of 19 patients with malignant tumours was 75.9%. Retention of the glenohumeral articulation (subtotal) resection gives superior functional results

Limb sparing surgery for bone tumours of the shoulder girdle: the oncological and functional results

It is a great challenge to spare the upper limb with a malignant or invasive benign bone tumour of the shoulder girdle. We retrospectively analysed 35 patients with bone tumours of the shoulder girdle treated with various limb salvage procedures. The tumours included 25 primary malignancies, three metastases and seven giant cell tumours which involved the proximal humerus in 21 patients, scapula in 12 and clavicle in two. The reconstruction procedures included eight prosthetic replacements, four devitalised tumorous bone grafts, three osteoarticular allografts, two autogenous fibular grafts, one intramedullary cemented nail, three Tikhoff-Linberg procedures, two replantation of shortened arms, and four humeral head suspensions. Six partial scapulectomies and two lateral clavicectomies needed no bone reconstruction. With an average follow-up of 71 months, local recurrences occurred in four cases and systemic metastases in six. Nine patients died and 23 remained disease free. The five year Kaplan-Meier survival rate of 28 patients with malignancies was 69.5%. The average Musculoskeletal Tumour Society (MSTS) functional score was 77% (range 40–100%) in all patients