The major variable is the presence or absence of the major motor group, the abductor mechanism. In the classification system, A denotes that the shoulder abductors have been spared, and B denotes that abductor muscles are partially or completely resected. The abductor mechanism is almost always resected when there is extraosseous extension of a bone tumor in this area. In general, Types I, II, and III resections are performed for benign or low-grade lesions of the proximal humerus or scapula. Types IV, V, and VI are most often used for the treatment of high-grade sarcomas of the scapula and humerus.
Patients undergoing shoulder girdle resection retain hand function and good elbow function.
From a rehabilitation perspective it clearly offers an outcome superior to a forequarter amputation or shoulder disarticulation procedure. Further, shoulder girdle resection is less disfiguring and is associated with only minimal pain and edema. The rehabilitation process begins with a patient orientation program, often showing pictures of patients who have undergone the procedure and demonstrating what one can do postoperatively and what limitations in function are likely to follow surgery. Preoperatively, a shoulder mold is fashioned, using the involved shoulder, provided its contours are not distorted. The cosmetic shoulder helps preserve the symmetry and appearance of the shoulder contour, and can support a bra strap or a heavy overcoat.