Patients with facioscapulohumeral dystrophy (FSHD) are affected mostly by impaired shoulder function. Scapulothoracic arthrodesis was introduced to improve shoulder function. We evaluated the outcomes of scapulothoracic arthrodesis using multifilament cables, performed on 13 patients with FSHD (18 shoulders). There were eight males and five females (mean age, 29 years; range, 20-50 years). Outcome criteria were active shoulder forward flexion and abduction, the Disabilities of the Arm, Shoulder, and Hand (DASH) score, respiratory function tests, and a new shoulder function score. Patients were followed for a minimum of 24 months (average, 35.5 months; range, 24-87 months). Solid fusion was obtained in all shoulders (two after revision); active abduction range increased from 47.2°± 11.6°to 102.2°± 10.0°(mean ± standard deviation) and anterior flexion range from 55.6°± 16.1°to 126.1°± 20.9°. The DASH score decreased from 33.6 ± 8.9 points preoperatively to 11.6 ± 8.0 points postoperatively. Shoulder function score increased from 15.9 ± 2.4 points to 22.2 ± 1.3 points. Scapulothoracic arthrodesis provides satisfactory function in patients with FSHD. Our data suggest use of multifilament cables for fixation is a reasonable option with an acceptable complication rate.
Objective: To evaluate and compare the nasal airway changes following rapid maxillary expansion (RME) and fan-type RME using acoustic rhinometry (AR). Materials and Methods: The study sample consisted of three groups. The RME group comprised 15 subjects with maxillary transverse discrepancies and posterior crossbites. The fan-type RME group comprised 15 subjects, who had an anteriorly constricted maxilla with a normal intermolar width. The third group included 15 patients who had an ideal occlusion and received no orthodontic treatment and served as the control group. AR was used to measure nasal volume and the minimal cross-sectional area (MCA) before expansion (T1), after expansion (T2), and 6 months after expansion (T3). Each AR recording was performed with and without the use of a decongestant. Two-way analysis of variance was used to determine differences among the groups and three-way analysis of variance was used for the differences between groups. If evidence of statistically significant differences was found, a Bonferroni test was used. Results: The results showed that nasal volume and MCA were significantly increased with RME and fan-type RME immediately after expansion (P , .05). At the end of retention, nasal volume and MCA values of RME showed significant differences with both expansion fan-type RME and control groups (P , .05). Conclusions: RME and fan-type RME had similar effects on the nasal airway immediately after expansion. The increase in nasal volume and MCA was more stable in the RME group than in the fan-type RME group at the end of the retention period. (Angle Orthod. 2010;80:870-875.)
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