Abstract:Case:
A 32-year-old male right-hand dominant school-bus driver with facioscapulohumeral dystrophy (FSHD) was referred to an upper limb specialist for consideration for scapulothoracic fusion (STF) because of limited upper limb function and cosmetic issues. Staged bilateral STFs were performed with seven high-strength suture tapes tensioned to secure a standard tubular plate in situ.
Conclusion:
STF may be a desirable treatment option for patients with F… Show more
“…The advent of UHMWPE-reinforced fiber sutures has provided high-strength alternative fixation methods to the classic steel wire construct options. 6 , 10 , 13 , 21 , 23 , 32 In this article, we present the case of a patient who underwent successful right scapulothoracic arthrodesis using UHMWPE sutures and steel plates.…”
“…6,32 Their use for the purposes of achieving a STF, however, is scarce, with only 3 reports describing 4 cases. 10,13,26 Therefore, the purposes of this study were to (1) report a case and surgical technique for STF using UHMWPE-reinforced suture fixation and (2) perform systematic literature review of Institutional review board approval was not required for this study. scapulothoracic arthrodesis methods evaluating technique, fusion, and reoperation.…”
mentioning
confidence: 99%
“…Scapular winging, instability, or dyskinesia can have a multitude of etiologies; these most commonly are due to direct neurologic injury to key nerves 4 , 16 , 19 , 22 , 26 , 27 , 29 or muscular wasting, such as in facioscapulohumeral muscular dystrophy. 1 , 2 , 16 , 17 , 18 , 20 , 22 , 23 , 24 , 25 , 28 , 29 , 3 , 31 , 33 , 5 , 8 , 9 , 10 , 11 , 12 , 14 Bony deformities including rib or scapular osteochondromas in multiple hereditary exostoses, glenoid instability, or scapular dislocations have also been indicated as causes. 13 , 15 , 16 , 19 , 22 , 29 If initial management of physical therapy and bracing fail to adequately resolve symptoms and prevent scapular winging, different surgical options can be considered.…”
mentioning
confidence: 99%
“… 6 , 32 Their use for the purposes of achieving a STF, however, is scarce, with only 3 reports describing 4 cases. 10 , 13 , 26 …”
Background: Historically, scapulothoracic fusion (STF) is performed using steel wire and plate construct fixation. The purpose of this study is to report a recent fusion achieved through ultra-high-molecularweight polyethylene-reinforced suture fixation as well as to perform a systematic literature review of techniques, fusion rates, complications, and reoperation. Methods: Patient data were gathered from chart review and clinical encounters. For the review, MED-LINE, Embase, and Ovid databases were queried for STF cases. Thirty articles reporting on 386 fusion procedures were included. Results: Including this patient, 5 of 387 (1.3%) STFs have been attempted with fiber suture. Fusion rates of metal-only constructs is 90.8% (346 of 381) with 11.3% (43 of 381) requiring wire removal or trimming because of symptomatic hardware and 7% (27 of 381) causing a postoperative pneumothorax. Although a small sample size, all fiber-suture constructs have achieved union without implant removal and without pneumothorax development. In this patient, fusion was determined radiographically at 6 months with substantial improvement in pain level and function. Conclusion: Scapulothoracic fusion has benefit to patients to have failed other management options for winged scapula, most commonly those with neurologic trauma or facioscapulohumeral muscular dystrophy. With advancements in surgical options, fiber-suture offers an alternative to steel wire to achieve fusion. Further cases with longer term follow-up are needed to determine if significant differences in outcomes exist between constructs.
“…The advent of UHMWPE-reinforced fiber sutures has provided high-strength alternative fixation methods to the classic steel wire construct options. 6 , 10 , 13 , 21 , 23 , 32 In this article, we present the case of a patient who underwent successful right scapulothoracic arthrodesis using UHMWPE sutures and steel plates.…”
“…6,32 Their use for the purposes of achieving a STF, however, is scarce, with only 3 reports describing 4 cases. 10,13,26 Therefore, the purposes of this study were to (1) report a case and surgical technique for STF using UHMWPE-reinforced suture fixation and (2) perform systematic literature review of Institutional review board approval was not required for this study. scapulothoracic arthrodesis methods evaluating technique, fusion, and reoperation.…”
mentioning
confidence: 99%
“…Scapular winging, instability, or dyskinesia can have a multitude of etiologies; these most commonly are due to direct neurologic injury to key nerves 4 , 16 , 19 , 22 , 26 , 27 , 29 or muscular wasting, such as in facioscapulohumeral muscular dystrophy. 1 , 2 , 16 , 17 , 18 , 20 , 22 , 23 , 24 , 25 , 28 , 29 , 3 , 31 , 33 , 5 , 8 , 9 , 10 , 11 , 12 , 14 Bony deformities including rib or scapular osteochondromas in multiple hereditary exostoses, glenoid instability, or scapular dislocations have also been indicated as causes. 13 , 15 , 16 , 19 , 22 , 29 If initial management of physical therapy and bracing fail to adequately resolve symptoms and prevent scapular winging, different surgical options can be considered.…”
mentioning
confidence: 99%
“… 6 , 32 Their use for the purposes of achieving a STF, however, is scarce, with only 3 reports describing 4 cases. 10 , 13 , 26 …”
Background: Historically, scapulothoracic fusion (STF) is performed using steel wire and plate construct fixation. The purpose of this study is to report a recent fusion achieved through ultra-high-molecularweight polyethylene-reinforced suture fixation as well as to perform a systematic literature review of techniques, fusion rates, complications, and reoperation. Methods: Patient data were gathered from chart review and clinical encounters. For the review, MED-LINE, Embase, and Ovid databases were queried for STF cases. Thirty articles reporting on 386 fusion procedures were included. Results: Including this patient, 5 of 387 (1.3%) STFs have been attempted with fiber suture. Fusion rates of metal-only constructs is 90.8% (346 of 381) with 11.3% (43 of 381) requiring wire removal or trimming because of symptomatic hardware and 7% (27 of 381) causing a postoperative pneumothorax. Although a small sample size, all fiber-suture constructs have achieved union without implant removal and without pneumothorax development. In this patient, fusion was determined radiographically at 6 months with substantial improvement in pain level and function. Conclusion: Scapulothoracic fusion has benefit to patients to have failed other management options for winged scapula, most commonly those with neurologic trauma or facioscapulohumeral muscular dystrophy. With advancements in surgical options, fiber-suture offers an alternative to steel wire to achieve fusion. Further cases with longer term follow-up are needed to determine if significant differences in outcomes exist between constructs.
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