Total scapulectomy and constrained reverse total shoulder reconstruction for a Ewing's sarcoma.
BACKGROUND
Total scapulectomy and intra-articular resection of the glenohumeral joint indicates the Malawer Type III shoulder girdle resection.


METHODS
The modified Tikhoff-Linberg total scapulectomy and constrained reverse total shoulder reconstruction for a Ewing's sarcoma of the scapula is presented. A combined approach has been used. The deltoid, trapezius, rhomboids, levator scapulae, latissimus dorsi, and serratus anterior were preserved. the tumor was removed en bloc by disarticulation of the acromioclavicular and the glenohumeral joints. The scapular prosthesis was suspended by the muscles. A constrained reverse humeral prosthesis was implanted after osteotomy of the humeral head.


RESULTS
There were no intraoperative or postoperative complications; surgical margins were clear. At 12 months postoperatively, the patient has a stable and painless shoulder.


CONCLUSIONS
The goal of shoulder reconstructions is to provide a stable and painless joint that allows positioning of the arm and hand in space. Compared to those patients left without a scapula reconstruction, prosthetic replacement of the scapula and shoulder partially restores abduction and external rotation and improves cosmesis.
Mavrogenis
Andreas F
AF
First Department of Orthopaedics, ATTIKON University Hospital, Athens Medical School, Athens Greece.
Mastorakos
Dimitrios P
DP
Triantafyllopoulos
Georgios
G
Sakellariou
Vasileios I
VI
Galanis
Evanthia C
EC
Papagelopoulos
Panayiotis J
PJ
D001859:Bone Neoplasms / Q000601:surgery*; D006801:Humans; D006811:Humerus / Q000601:surgery; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D019736:Prostheses and Implants; D012512:Sarcoma, Ewing / Q000601:surgery*; D012540:Scapula / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*