Is scapular endoprosthesis functionally superior to humeral suspension?

Tamir Pritsch, Jacob Bickels, Chia Chun Wu, Malcolm H. Squires, Martin M. Malawer

Research output: Contribution to journalArticlepeer-review

Abstract

Humeral suspension was the most popular reconstructive procedure after total scapulectomy until the early 1990s. Since 1992 the senior author has been performing scapular endoprosthetic reconstruction after total scapulectomy whenever the rhomboids, latissimus dorsi, deltoid, and trapezius were preserved. We hypothesized that scapular endoprosthetic reconstruction resulted in better functional and cosmetic results than humeral suspension. From 1979 to 2003, 32 consecutive patients had total scapulectomies. Reconstructions included humeral suspensions in 16 patients and scapular endoprostheses in 16 patients. Functional and cosmetic results were compared retrospectively between the two groups. Patients with scapular endoprostheses had better functional results and superior cosmesis as compared with patients with humeral suspension. The mean Musculo-skeletal Tumor Society scores for patients with scapular endoprostheses and humeral suspensions were 78.5% and 58.5% respectively. Seven patients with scapular endoprostheses had greater than 40° abduction and 11 patients with humeral suspensions could not abduct the shoulder greater than 20°. Twelve patients with humeral suspensions and none with scapular endoprostheses wore shoulder pads or customized orthoses for cosmetic purposes. After total scapulectomy, scapular endoprosthetic reconstruction led to better functional and cosmetic results than humeral suspension and therefore we recommend performing this reconstructive procedure whenever the rhomboids, latissimus dorsi, deltoid, and trapezius are preserved. Level of Evidence: Level III, therapeutic study (retrospective comparative study). See the Guidelines for Authors for the complete description of level of evidence.

Original languageEnglish
Pages (from-to)188-195
Number of pages8
JournalClinical Orthopaedics and Related Research
Volume456
DOIs
StatePublished - 2007
Externally publishedYes

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