Extracorporeally irradiated scapula as autograft in tumor surgery

Reconstruction with constrained scapular prosthesis after total scapulectomy for scapular malignant tumor

“…However, surgical treatment presents a great challenge when the whole scapula is resected. Various methods, including humeral suspension, scapular allograft or autograft replacement and prosthetic implantation, have been described . Humeral suspension after total scapulectomy could achieve satisfactory tumor resection, with a low complication rate; however, this technique was associated with floating humerus (flail shoulder), poor cosmetic outcomes, and restricted joint functions .…”

“…Various methods, including humeral suspension, scapular allograft or autograft replacement and prosthetic implantation, have been described. 3,7,9,[11][12][13][14] Humeral suspension after total scapulectomy could achieve satisfactory tumor resection, with a low complication rate; however, this technique was associated with floating humerus (flail shoulder), poor cosmetic outcomes, and restricted joint functions. 9,12,24,25 Of note, this technique is still an option if no further reconstruction is possible.…”

“…Although a good postoperative function was reported in a few studies on structural scapular allograft or autograft reconstruction, limited availability of allograft, and high complication rate (14-67%) may greatly limit this technique. [13][14][15][16]26 Additionally, reconstruction with massive allograft is almost impossible to procure without a bone bank.…”

“…However, surgical reconstruction presents a great challenge when the whole scapula is resected. Many methods, such as humeral suspension, autograft, or allograft replacement of scapula and use of scapular prosthesis, have been used for reconstruction after total scapulectomy . Of these methods, the prosthetic reconstruction is considered as the most effective method because of acceptable cosmesis, good postoperative function, and relatively low complication rate .…”

“…Many methods, such as humeral suspension, autograft, or allograft replacement of scapula and use of scapular prosthesis, have been used for reconstruction after total scapulectomy. 4,[7][8][9][10][11][12][13][14][15][16][17] Of these methods, the prosthetic reconstruction is considered as the most effective method because of acceptable cosmesis, good postoperative function, and relatively low complication rate. 3,4,[7][8][9][10][11] Generally, there are two kinds of scapular prosthesis: nonconstrained and constrained.…”