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Function after subtotal scapulectomy for neoplasm of bone and soft tissue
C L Gibbons1, R S Bell, J S Wunder
1Mount Sinai Hospital, Toronto, Canada.
The Journal of Bone and Joint Surgery. British Volume
|February 14, 1998
Summary
Subtotal scapulectomy for bone and soft-tissue tumors yields good to excellent functional results when the glenohumeral joint is preserved. Preserving the deltoid and trapezius muscles is key for optimal outcomes.
Area of Science:
- Orthopedic Oncology
- Musculoskeletal Tumors
- Surgical Oncology
Background:
- Subtotal scapulectomy is a surgical procedure for primary bone and soft-tissue tumors of the scapula.
- Functional outcomes after this procedure are crucial for patient quality of life.
Purpose of the Study:
- To evaluate the functional results of subtotal scapulectomy in patients with primary bone and soft-tissue tumors.
- To identify factors influencing functional outcomes after scapula resection.
Main Methods:
- Retrospective analysis of 14 patients undergoing subtotal scapulectomy.
- Assessment of functional outcomes using the Musculoskeletal Tumour Society (MSTS) rating scale and Toronto Extremity Salvage Score (TESS).
- Mean follow-up of 52 months.
Main Results:
- All 14 patients survived; two had systemic disease.
- Nine patients had >80% scapula resected, with glenohumeral joint preservation in all.
- Good to excellent functional results (mean MSTS=71.6, TESS=79.9) in 11/14 patients; three experienced pain due to brachial neuropathy.
Conclusions:
- Subtotal scapulectomy provides excellent functional outcomes when the glenohumeral joint is preserved.
- Rotator cuff resection is feasible without severe functional deficit if the deltoid is reattached to the scapular remnant and trapezius.
- Preservation of the glenohumeral joint is critical for successful functional recovery.