Historical Perspective


Forequarter amputation is performed for the first time for cancer.5


The first partial scapulectomy is performed for an ossified aneurysmal tumor.6 


Mussey performs a near-total scapulectomy for chondrosarcoma.3 


Total scapulectomy is first described in the literature by Syme.8 


Prashnikov, a Russian surgeon, describes a case of scapulectomy, with removal of surrounding soft tissue, head of the humerus, and distal third of the clavicle, with reattachment of the remaining humerus to the remaining clavicle using metal sutures.3

Bauman and Tikhoff, both Russian surgeons, perform 3 such procedures.9 


de Nancrede describes scapulectomy as an inferior surgical procedure compared with forequarter amputation.8 


Bauman publishes a Russian-language version of his experience with resection of tumors of the shoulder.9 


Boris Edmundovich Linberg publishes an English-language version of his experience perfoming the procedure and credits Tikhoff with its initiation.10 


Pack and Crampton begin to again employ scapular resections, particularly Tikhoff-Linberg, after nearly 50 years with only a handful of cases.8 Note the cosmetic results (left) and surgical technique (right).

Image from 8. 


Burwell publishes a case report about a patient with a large scapular sarcoma treated by block resection of the shoulder, with the rest of the limb left intact .11

A description of 26 scapulectomies is published by Papioannou and Francis.12 


Marcove publishes his experience performing the Tikhoff-Linberg procedure on 17 patients. He uses an intramedullary prosthesis (Kuntscher nail) to lengthen the humerus and secure it to the second rib or clavicle.13

Image from 13. 


Whitehill attaches the Kuntscher nail to a ring attached to the second rib.14 Image from 14. 


Malawer advocates the use of a modified Tikhoff-Linberg procedure for large tumors of the proximal humerus. He highlights his "dual suspension" technique of reconstruction.15 


Craig and Thompson report no difference in local recurrence, distant metastases, or survival between amputations and limb-salvage procedures.16 


More reconstructive efforts after limb-sparing surgery are published.

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