Scapulothoracic fusion: outcomes and complications

Area of Science:

• Orthopedic surgery
• Shoulder reconstruction
• Scapulothoracic fusion

Background:

• Scapulothoracic fusion (STF) is a surgical option for managing painful scapular winging.
• This condition can significantly impair shoulder function and quality of life.

Purpose of the Study:

• To evaluate the clinical outcomes of patients who underwent STF for painful scapular winging.
• To assess the effectiveness of STF in pain alleviation and functional restoration.

Main Methods:

• Retrospective review of 10 patients (12 shoulders) who underwent STF between 1999 and 2008.
• Indications included clavicular resection, facioscapulohumeral dystrophy, and nerve palsies causing scapular winging.
• Outcomes measured included subjective shoulder value, VAS pain scores, range of motion, union rates, and complications.

Main Results:

• Statistically significant improvements were observed in subjective shoulder value, VAS scores, range of motion, and patient satisfaction.
• The overall complication rate was 50%, with 17% nonunion and 50% requiring hardware removal due to discomfort.
• Specific complications included pleural effusion, hemopneumothorax, pulmonary embolism, and infection, all resolving without long-term sequelae except for one revision nonunion.

Conclusions:

• Scapulothoracic fusion effectively improves function and relieves pain in patients with scapular winging.
• While STF is associated with a high short-term complication rate, long-term sequelae are generally limited.