Successful limb salvage and favorable functional outcome after subtotal scapulectomy and custom 3D-printed reconstruction in a 14-year-old with high-grade osteosarcoma.
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Scapular reconstruction following tumor resection remains a surgical challenge because of the scapula's essential role in upper extremity biomechanics. Although patient-specific implants have expanded reconstructive options, achieving durable fixation and functional restoration remains difficult. A 14-year-old male with high-grade osteosarcoma of the scapular wing underwent limb-salvage surgery using a custom 3D-printed endoprosthesis. Preoperative planning incorporated dedicated software and patient-specific cutting guides. Wide resection preserved a small portion of the glenoid and the native glenohumeral joint to maximize postoperative function. At 3 months, radiographs demonstrated early osseointegration. The patient achieved 100° of active shoulder abduction without scapular winging or instability. At 2 years, he maintained near-full motion, demonstrated stable implant integration without loosening or recurrence, and returned to sports and daily activities with minimal limitations. Patient-specific scapular endoprosthetic reconstruction can achieve excellent oncologic and functional outcomes after subtotal scapulectomy, even in very young patients with high-grade malignancy.