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Background: Scapulothoracic arthrodesis is a recognized treatment for impaired shoulder function in patients with facioscapulohumeral dystrophy (FSHD) and is traditionally performed with autograft. The purpose of the study was to report our experience with scapulothoracic arthrodesis in patients with FSHD using allograft, rather than autograft, with particular respect to the effect of fusion on preoperative and postoperative Disabilities of the Arm, Shoulder and Hand (DASH) scores; forced vital capacity (FVC); and complications.Materials and methods: The early results of 14 consecutive scapulothoracic arthrodeses in FSHD patients with cerclage wires, plates, and allograft (fresh-frozen femoral heads) are reported. DASH scores were recorded preoperatively and 6 months postoperatively. Preoperative and 6-month FVCs were compared. The surgical technique is described.Results: Eleven patients underwent 14 fusions. The mean follow-up period was 29 months (range, 6-50 months). Forward flexion improved from 70 degrees to 115 degrees (P = .001) and abduction from 68 degrees to 109 degrees (P = .007). The DASH score improved from 48 points to 34 points (P = .005). FVC decreased from 98% to 92% of predicted (P = .021), although this was not clinically significant. One patient required revision for nonunion, and metalwork was removed in 5 scapulae. A postoperative chest infection developed in 1 patient and a pleural effusion in another. One brachial plexus palsy occurred, which had almost completely resolved by 27 months postoperatively.Conclusion: Scapulothoracic arthrodesis can be performed successfully with allograft. The nonunion and complication rates are similar to those in the existing literature. A small decrease in FVC does occur but not to a clinically significant level. Level of evidence: Level IV, Case Series, Treatment Study. (C) 2014 Journal of Shoulder and Elbow Surgery Board of Trustees.
Author(s): Cooney AD, Gill I, Stuart PR
Publication type: Article
Publication status: Published
Journal: Journal of Shoulder and Elbow Surgery
Year: 2014
Volume: 23
Issue: 1
Pages: E8-E13
Print publication date: 01/01/2014
ISSN (print): 1058-2746
ISSN (electronic): 1532-6500
Publisher: Mosby, Inc.
URL: http://dx.doi.org/10.1016/j.jse.2013.04.012
DOI: 10.1016/j.jse.2013.04.012
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