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What Is Scapulectomy?

Scapulectomy is limb-sparing surgery that removes part or all of the scapula, commonly called the shoulder blade. It is most often performed for a primary malignant bone or soft-tissue tumor involving the scapula. A partial scapulectomy preserves uninvolved portions of the bone and can preserve the glenoid and shoulder joint when oncologically safe, while a total scapulectomy removes the entire scapula. The arm itself is preserved when major neurovascular structures can remain intact and adequate tumor margins can be achieved.

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What Is Scapulectomy?

Scapulectomy is limb-sparing surgery that removes part or all of the scapula, commonly called the shoulder blade. It is most often performed for a primary malignant bone or soft-tissue tumor involving the scapula. A partial scapulectomy preserves uninvolved portions of the bone and can preserve the glenoid and shoulder joint when oncologically safe, while a total scapulectomy removes the entire scapula. The arm itself is preserved when major neurovascular structures can remain intact and adequate tumor margins can be achieved.

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Why Is Scapulectomy Performed?

The procedure is used for selected scapular tumors that require wide surgical removal but do not require amputation of the entire upper extremity. Chondrosarcoma, osteosarcoma, Ewing sarcoma, and selected soft-tissue sarcomas can involve the scapula and require partial, subtotal, or total resection. Surgeons aim to preserve as much scapular bone, glenohumeral anatomy, muscle, and neurovascular function as possible without compromising the cancer margin. Partial resections generally provide better shoulder function than total scapulectomy when the tumor location allows a safe limb-sparing operation.

How Is Scapulectomy Performed?

The surgical team exposes the shoulder girdle and removes the involved portion of the scapula together with a planned margin of surrounding tissue. During partial scapulectomy, uninvolved scapular structures and the glenoid can be preserved when they are safely outside the tumor. Total scapulectomy removes the entire scapula while preserving the arm, major blood vessels, and brachial plexus when possible. Soft-tissue reconstruction, humeral suspension, tendon reattachment, muscle transfer, or prosthetic reconstruction can be used to stabilize the shoulder region after extensive resection.

What Is Recovery Like After Scapulectomy?

Recovery focuses on wound healing, pain control, protection of reconstructed soft tissues, and gradual rehabilitation of the remaining upper extremity. Shoulder motion and strength are often reduced, especially after total scapulectomy, because the scapula provides the normal foundation for shoulder movement. Elbow, wrist, and hand function can remain relatively well preserved when their nerves, vessels, and muscles are intact. Physical and occupational therapy help patients maximize positioning, reaching, hand use, and daily function over several months.

What Are the Risks and Complications?

Possible complications include bleeding, infection, wound breakdown, skin or flap necrosis, nerve injury, vascular injury, and shoulder instability. Extensive muscle or nerve resection can lead to substantial weakness, limited shoulder elevation, chronic pain, or an unstable flail shoulder. Reconstruction can fail or require revision, particularly after large total resections or previous radiation therapy. Local tumor recurrence or metastatic disease can still occur despite adequate surgical removal.

Frequently Asked Questions About Scapulectomy

What is the difference between partial and total scapulectomy?

Partial scapulectomy removes only the involved portion of the shoulder blade, while total scapulectomy removes the entire scapula.

Is the arm removed during scapulectomy?

No. Scapulectomy is a limb-sparing procedure that preserves the arm when major nerves and blood vessels can be retained and adequate tumor margins are possible.

Can hand function remain after total scapulectomy?

Yes. Published series show that elbow, wrist, and hand function can remain useful even when shoulder motion is substantially reduced after total scapulectomy.

Why is partial scapulectomy preferred when possible?

Preserving more scapula, especially the glenoid and surrounding muscles, generally produces better shoulder function while still allowing adequate tumor removal in suitable cases.

References

Malignant tumors of the shoulder girdle: Surgical and functional outcomes. PubMed. https://pubmed.ncbi.nlm.nih.gov/30939977/. Date Accessed September 11, 2026.

Functional outcomes after total scapulectomy for malignant bone or soft tissue tumors in the shoulder girdle. PubMed. https://pubmed.ncbi.nlm.nih.gov/21480004/. Date Accessed September 11, 2026.

What is the patient acceptance when only scapulectomy is possible in case of malignant tumor? A case series. PubMed. https://pubmed.ncbi.nlm.nih.gov/36353438/. Date Accessed September 11, 2026.

Scapulectomy for malignant tumor. Function and shoulder strength in five patients. PubMed. https://pubmed.ncbi.nlm.nih.gov/4072651/. Date Accessed September 11, 2026.

Excellent shoulder function is attainable after partial or total scapulectomy. Analysis at prolonged follow-up. PubMed. https://pubmed.ncbi.nlm.nih.gov/2322121/. Date Accessed September 11, 2026.