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.

1st Department of Orthopaedics National and Kapodistrian University of Athens School of Medicine 41 Ventouri Street 15562 Holargos Athens Greece

Department of Orthopaedics 1st Medical Faculty Charles University Prague Teaching Hospital Bulovka Prague Czechia

Orthopaedic Service Department of Surgery Memorial Sloan Kettering Cancer Center 1275 York Avenue 10065 New York NY USA

Zobrazit více v PubMed

Surgery. 1985 May;97(5):518-28 PubMed

J Surg Oncol. 1993 Jun;53(2):71-7 PubMed

Clin Orthop Relat Res. 2009 Apr;467(4):1035-41 PubMed

J Shoulder Elbow Surg. 2007 May-Jun;16(3):273-9 PubMed

Arch Orthop Trauma Surg. 1990;109 (2):63-7 PubMed

Ann Thorac Surg. 2006 Jan;81(1):279-85 PubMed

Ital J Orthop Traumatol. 1985 Jun;11(2):151-7 PubMed

Clin Orthop Relat Res. 1991 Jun;(267):33-44 PubMed

Yonsei Med J. 1990 Jun;31(2):110-22 PubMed

Orthop Clin North Am. 2014 Oct;45(4):541-64 PubMed

Arch Surg. 1999 Mar;134(3):252-7 PubMed

Orthopedics. 2014 Sep;37(9):585-8 PubMed

Oncology. 2001;60(1):55-9 PubMed

Clin Orthop Relat Res. 2004 Jun;(423):191-5 PubMed

SICOT J. 2016;2:34 PubMed

Instr Course Lect. 2004;53:639-44 PubMed

Eur J Orthop Surg Traumatol. 2015 Jan;25(1):5-15 PubMed

J Bone Joint Surg Br. 2004 May;86(4):531-5 PubMed

J Bone Joint Surg Am. 1999 Aug;81(8):1138-46 PubMed

Orthop Clin North Am. 1991 Jan;22(1):7-35 PubMed

J Bone Joint Surg Am. 1962 Oct;44-A:1423-30 PubMed

Clin Orthop Relat Res. 1986 Mar;(204):9-24 PubMed

Clin Orthop Relat Res. 1977 May;(124):219-28 PubMed

Surg Oncol. 1996 Feb;5(1):43-8 PubMed

Recent Results Cancer Res. 2009;179:243-56 PubMed

J Bone Joint Surg Br. 2002 Sep;84(7):1004-8 PubMed

J Surg Oncol. 2009 Dec 1;100(7):611-5 PubMed

Acta Chir Orthop Traumatol Cech. 1999;66(2):76-81 PubMed

J Shoulder Elbow Surg. 2014 Jun;23(6):e127-33 PubMed

Clin Orthop Relat Res. 2007 Mar;456:188-95 PubMed

Br J Surg. 2009 Jul;96(7):792-8 PubMed

J Surg Oncol. 2001 Jun;77(2):105-13; discussion 114 PubMed

Arch Bone Jt Surg. 2013 Sep;1(1):2-4 PubMed

J Shoulder Elbow Surg. 2017 Jul 6;:null PubMed

J Bone Joint Surg Am. 2009 Oct;91(10):2406-15 PubMed

J Bone Joint Surg Am. 1996 Dec;78(12):1872-88 PubMed

Acta Orthop Scand. 1994 Feb;65(1):55-61 PubMed

Int Orthop. 2010 Aug;34(6):869-75 PubMed

Clin Orthop Relat Res. 1998 Mar;(348):124-34 PubMed

Clin Orthop Relat Res. 2006 Jun;447:132-7 PubMed

Optimized prosthetic design, surgical technique, and cosmetic outcome in shoulder reconstruction with double-constrained implant following extra-articular shoulder resection: a proof-of-concept

Reconstruction with a double-constrained implant design after complex shoulder extra-articular resection