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Shoulder girdle resection: surgical technique modification and introduction of a new classification system
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Shoulder girdle resection: surgical technique modification and introduction of a new classification system
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Journal Article
Shoulder girdle resection: surgical technique modification and introduction of a new classification system
2019
Overview
Objective
Different classification systems for surgical tumor resections in the proximal humerus and scapula have been described, but none are specific or have been recently revised. The purpose of this article is to report modified surgical techniques and a new classification system for resections in the humerus and scapula.
Methods
Thirty-two patients with shoulder girdle bone tumors were operated upon. Two separate new classifications were assigned to resections in the humerus (types I–IV) and scapula (types I–III). An annotation is added to signify deltoid preservation (A) or sacrifice (B). Modified surgical techniques were devised.
Results
For extra-articular resections of the proximal humerus, we show that sacrificing the acromion and coracoid process is not required. Preservation of these structures can improve cosmetic shoulder outcome. For tumors with no large medial component, we show that there is no need to detach the muscle attachment from the coracoid process allowing earlier elbow extension postoperatively. After a mean follow-up period of 46 months, only two patients developed local recurrence. Postoperative infection was seen in two and stem loosening in one patient. The average MSTS functional score for all patients was 83%.
Conclusion
Our modified surgical techniques saved structures which were unnecessarily resected with no advantage in surgical series. We reserved the integrity of more muscular tissues and attachments leading to less restriction during the rehabilitation process. This new classification system is realistic, easy to implement, and applicable to all patients.
Publisher
BioMed Central,BioMed Central Ltd,BMC
Subject
/ Adult
/ Biopsy
/ Child
/ Editing
/ Elbow
/ Female
/ Humans
/ Humerus
/ Male
/ Medicine
/ Muscles
/ Neoplasm Recurrence, Local - epidemiology
/ Neoplasm Recurrence, Local - prevention & control
/ Organ Sparing Treatments - adverse effects
/ Organ Sparing Treatments - classification
/ Organ Sparing Treatments - methods
/ Orthopedic Procedures - adverse effects
/ Orthopedic Procedures - classification
/ Orthopedic Procedures - methods
/ Patients
/ Postoperative Complications - epidemiology
/ Postoperative Complications - etiology
/ Scapula
/ Shoulder
/ Tumors
