Function correlates with deltoid preservation in patients having scapular replacement.
Advocates of scapular replacement suggest sparing the deltoid should be a prerequisite for use of a scapular prosthesis. We evaluated the importance of a functioning deltoid in scapular replacement for malignant tumors. We retrospectively reviewed 19 patients who received scapular prostheses after resection of a malignant tumor. The median followup was 18 months (range, 12-124 months). The axillary nerve was resected in eight patients and spared in 11 patients. The average International Society of Limb Salvage score was 25 of 30 points (range, 21-27 points). The average scores for patients with and without axillary nerve resection were 24 points (range, 21-25 points) and 26 points (range, 23-27 points), respectively. There was a difference between the two groups in hand positioning, overall function, and pain. However, there were no differences in emotional acceptance, lifting ability, or hand dexterity. We favor using a scapular prosthesis if there is a functioning deltoid; however resection of the deltoid should not be considered an absolute contraindication for scapular replacement.
Schwab
Joseph H
JH
Orthopaedic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10021, USA.
Athanasian
Edward A
EA
Morris
Carol D
CD
Boland
Patrick J
PJ
Healey
John H
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D019643:Arthroplasty, Replacement / Q000379:methods*; D001859:Bone Neoplasms / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology; D019736:Prostheses and Implants; D012189:Retrospective Studies; D012540:Scapula / Q000601:surgery*