Journal of Experimental & Clinical Cancer Research Research Surgical technique and clinical results for scapular allograft reconstruction following resection of scapular tumors Kaiwei Zhang, Hong Duan, Zhou Xiang and Chongqi Tu* BioMed Central Open Access Address: Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, 610041, PR China Email: Kaiwei Zhang - zkw1973@yahoo.com.cn; Hong Duan - duanhong1970@yahoo.com.cn; Zhou Xiang - xiangzhou15@hotmail.com; Chongqi Tu* - tuchongqi@live.cn * Corresponding author Published: 1 April 2009 Journal of Experimental & Clinical Cancer Research 2009, 28:45 doi:10.1186/1756-9966-28-45 This article is available from: http://www.jeccr.com/content/28/1/45 Received: 30 December 2008 Accepted: 1 April 2009 © 2009 Zhang et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Progress in developing effective surgical techniques, such as scapular allograft reconstruction, enhance shoulder stability and extremity function, in patients following scapular tumor resection. Methods: Case details from seven patients who underwent scapular allograft reconstruction following scapular tumor resection were reviewed. A wide marginal resection (partial scapulectomy) was performed in all patients and all affected soft tissues were resected to achieve a clean surgical margin. The glenoid-resected and glenoid-saved reconstructions were performed in three and four patients, respectively. The residual host scapula were fixed to the size-matched scapular allografts with plates and screws. The rotator cuff was affected frequently and was mostly resected. The deltoid and articular capsule were infrequently involved, but reconstructed preferentially. The remaining muscles were reattached to the allografts. Results: The median follow-up was 26 months (range, 14–50 months). The average function scores were 24 points (80%) according to the International Society of Limb Salvage criteria. The range of active shoulder abduction and forward flexion motion were 40°–110° and 30°–90°, respectively. There was no difference between the glenoid-saved and glenoid-resected reconstructions in the total scores (mean, 24.5 points/81% versus 24 points/79%), but the glenoid- saved procedure was superior to the later in terms of abduction/flexion motion (mean, 72°/61° versus 55°/43°). During the study follow-up period, one patient died following a relapse, one patient lived despite of local recurrence, and five patients survived with no evidence of recurrence of the original cancer. Post-surgical complications such as shoulder dislocations, non-unions, and articular degeneration were not noted during this study period. Conclusion: Scapular allograft reconstruction had a satisfactory functional, cosmetic, and oncological outcome in this case series. Preservation and reconstruction of the articular capsule and deltoid are proposed to be a prerequisite for using scapular allografts and rotator cuff reconstruction is recommended, although technically challenging to perform. Page 1 of 10 (page number not for citation purposes)