Scapular Resection and Reconstruction

This chapter discusses the surgical management of scapular tumors, highlighting the challenges posed by the region's complex anatomy and its critical role in shoulder girdle function. Historically managed with forequarter amputation, scapular tumors are now more commonly treated with limb-sparing resections, facilitated by advances in imaging, chemotherapy, and reconstructive techniques. The chapter reviews indications and contraindications for scapulectomy, emphasizing oncological safety while striving to preserve elbow, wrist, and hand function. It outlines key anatomical considerations, classification systems such as those of Malawer and Enneking, and the technical aspects of resection. Reconstruction strategies are presented, ranging from nonanatomic humeral suspension and mesh-based techniques to biological allografts and modern endoprosthetic replacements, including the use of 3D-printed implants. Functional outcomes, complication profiles, and the importance of preserving muscles such as the deltoid and trapezius are critically evaluated. Rehabilitation principles are also addressed, underlining their role in maximizing function and quality of life. By integrating surgical principles with contemporary reconstructive options, this chapter provides a comprehensive framework for achieving durable, functional, and oncologically safe outcomes in scapular resections.