Extremity saving surgery and reconstruction for tumors of the scapula

Objectives: The aim of this study was to evaluate the results of extremity saving surgery and reconstruction with a scapular prosthesis in patients with scapula tumors. Methods: Seven patients (1 woman, 6 men; mean age 53 years; range 39 to 75 years) underwent partial or total scapulectomy followed by reconstruction with fibular autograft (n=1) or a scapular prosthesis (n=6) for bone or soft tissue scapular tumors. Latissimus dorsi muscle flap was used for the reconstruction of soft tissues. Postoperative adjuvant chemotherapy and/or radiotherapy were used depending on the primary pathology. Functional evaluations were made using the scores of the Musculoskeletal Tumor Society (M S T S ) . The mean follow-up period was 35 months (range 18 to 53 months). Results: No major surgical complications occurred in the early postoperative period. Two patients died due to distant metastasis. One patient was lost to follow-up in the second year. The first patient of the series in whom an unconstrained prosthesis was used had severe instability. Overall, despite some limitation in the movements of the shoulder (active shoulder abduction: 20°-90°), elbow and hand functions were near-normal. The mean M S T S functional score was 22 (range 18 to 25); four patients had good or very good results. The results were more satisfactory (abduction: 45°-90°, mean MSTS score 24) in patients with well-controlled primary disease and in whom a constrained prosthesis was used. Conclusion: Stability and function can be increased with limb salvage surgery, reconstruction of the scapular triangle with a prosthesis, and re-attachment of preserved muscles to the new scapular body.