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Scapulothoracic arthrodesis: indications, technique, and results.
Sumant G Krishnan1, Richard J Hawkins, John D Michelotti
1Department of Shoulder Service, W. B. Carrell Memorial Clinic, Dallas, TX, USA.
Clinical Orthopaedics and Related Research
|June 3, 2005
Summary
Scapulothoracic arthrodesis surgery can significantly reduce pain and improve shoulder function for patients with severe scapular dysfunction. However, this procedure has a high complication rate, requiring careful consideration.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Disorders
- Reconstructive Surgery
Background:
- Scapulothoracic arthrodesis addresses debilitating conditions like facioscapulohumeral muscular dystrophy and scapular winging.
- Patients often experience severe pain and functional loss, frequently with prior unsuccessful shoulder surgeries.
Purpose of the Study:
- To evaluate the efficacy of scapulothoracic arthrodesis in stabilizing the scapulothoracic articulation.
- To assess pain relief and functional improvement in patients with symptomatic scapular dysfunction.
Main Methods:
- A case series of 22 patients (24 shoulders) undergoing scapulothoracic arthrodesis.
- Utilized a plate and wire construct with autograft or allograft bone, followed by 12 weeks of immobilization.
Main Results:
- 91% of patients reported improved shoulder pain and functional satisfaction post-surgery.
- Complications were frequent, occurring in over 50% of patients, including pulmonary issues, hardware failure, and pseudarthrosis.
Conclusions:
- Scapulothoracic arthrodesis offers significant functional and pain benefits for debilitating scapulothoracic dysfunction.
- The high complication rate necessitates careful patient selection and management.
