Glenothoracic fusion

Background and Objectives We aimed to identify the overall survival (OS), surgical complications, survival of reconstruction, and functional outcome of patients who underwent extra‐articular resection of the shoulder joint for primary bone sarcomas. The OS and local recurrence rates in patients who underwent an amputation were also evaluated for comparison. Methods Thirty‐two patients treated between 1988 and 2017 were studied. The tumours were located in the humerus in 22 (69%) and scapula in 10 patients (31%). The resection types were Malawer type IV in 6 (19%), type V in 21 (66%), and type VI in 5 patients (15%). Reconstruction was performed with endoprosthesis in 23 patients (72%) while excision arthroplasty with the suspension of the humerus to the clavicle was performed in 9 patients (28%). Surgical margins were wide in 16, marginal in 8, intralesional in 3, and not available in 5 patients. During the study period, 40 patients underwent a forequarter amputation and 11 patients underwent a shoulder disarticulation. Results The 5‐year OS for patients who underwent extra‐articular resection of the shoulder joint was 42% which was not statistically different compared with that of patients who underwent amputation (5‐year OS = 30%; P = .091). The 5‐year survival of the reconstruction was 94%, similar for endoprosthesis and excision arthroplasty. Local recurrence and complications developed in 6 (19%) and 10 patients (31%), respectively. Failures of the reconstruction requiring revision surgery occurred in two patients (6%). Limb salvage was achieved in 30 patients (94%). The median Musculoskeletal Tumour Society functional score was 61% (interquartile range, 57%‐70%) and was similar in the endoprosthesis and excision arthroplasty group. Conclusions Extra‐articular resection of the shoulder joint for bone sarcomas is an effective limb‐salvage method. However, local recurrence remains a principal concern.

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Complex surgery for locally advanced bone and soft tissue sarcomas of the shoulder girdle

Lesenský

Mavrogenis

Igoumenou

et al. 2017

Eur J Orthop Surg Traumatol

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Surgical management of primary musculoskeletal tumors of the shoulder girdle is cognitively and technically demanding. Over the last decades, advances in the medical treatments, imaging and surgical techniques have fostered limb salvage surgery and reduced the need for amputation. Despite well-accepted general principles, an individualized approach is often necessary to accommodate tumor extension, anatomical challenges and patient characteristics. A combination of techniques is often required to achieve optimal oncologic and durable functional outcome. Goal of this article is to review approach and management of patients with locally advanced sarcomas of the shoulder girdle requiring major tumor surgery, to illustrate principles of surgical strategy, outcome and complications, and to provide useful guidelines for the treating physicians.

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Glenothoracic fusion

Cited by 9 publications

References 9 publications

Total scapulectomy and constrained reverse total shoulder reconstruction for a Ewing's Sarcoma

Total scapulectomy and constrained reverse total shoulder reconstruction for a Ewing's Sarcoma

Extra‐articular resection of shoulder joint for bone sarcomas: Oncologic and limb‐salvage outcomes of 32 cases compared with shoulder disarticulation and forequarter amputation

Complex surgery for locally advanced bone and soft tissue sarcomas of the shoulder girdle

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