October 20 2022
Total scapula replacement! One year follow up! Young teenage patient had an intraarticular resection and free non vascularized fibula for an osteosarcoma in another country. The osteosarcoma recurred along the scapula and the fibula was eroding through the skin. Patient underwent chemo and then limb sparing surgery and more chemo. This is a constrained total scapula. In order to perform the replacement must be able to preserve the deltoid, axilllary nerve, rhomboids, latissimus and trapezius. The serratus is a plus to cushion the rib cage. These muscles are used to rotate over the prosthesis, cover it and get it to function. See schematic. In my opinion, patients seem to have a stable shoulder for good elbow and hand function and better cosmesis than leaving the arm flail. It is certainly not without potential complications. This patient did very well.