Scapulectomy for malignant tumor. Function and shoulder strength in five patients

Area of Science:

• Orthopedic Surgery
• Oncology
• Rehabilitation Medicine

Background:

• Scapulectomy, the surgical removal of the scapula (shoulder blade), is a necessary procedure for treating malignant tumors affecting this bone.
• The extent of scapular resection, whether total or subtotal, can significantly influence postoperative functional outcomes and shoulder strength.

Purpose of the Study:

• To evaluate the functional and muscular strength outcomes in patients following total or subtotal scapulectomy for malignant tumors.
• To compare the functional differences between patients who underwent total versus subtotal scapulectomy.

Main Methods:

• A cohort of five patients who underwent scapulectomy for malignant tumors were assessed.
• Functional assessments included range of motion (flexion and abduction) and the ability to handle objects overhead.
• Isometric muscle strength was measured and compared to the non-operated side for both flexion and abduction.

Main Results:

• Patients with subtotal scapulectomy demonstrated significantly better shoulder function, including overhead object manipulation and reaching near-horizontal planes in flexion/abduction.
• Patients with total scapulectomy had limited shoulder range of motion (40-50 degrees) and substantially reduced muscle strength (14-17% of the non-operated side).
• Subtotal scapulectomy patients retained 37% flexion and 44% abduction strength compared to the contralateral side.

Conclusions:

• Subtotal scapulectomy generally results in better functional recovery and preserved muscle strength compared to total scapulectomy.
• Preserving key anatomical structures like the glenoid fossa and acromion during scapulectomy is crucial for optimizing shoulder function post-surgery.