Medium to Long-Term Outcome of Thoracoscapular Arthrodesis with Screw Fixation for Facioscapulohumeral Muscular Dystrophy

Facioscapulohumeral Muscular Dystrophy

“…39, 40 Scapulodesis (the fixation of the scapula with screws, wires or plates) with bone grafting is the preferred surgical procedure. Despite that there are no randomized trials to support the benefit seen in observational studies; nor are there clear recommendations on which patients are most likely to benefit from this procedure or the optimal timing of surgery.…”

Thoracoscapular Fusion for Winging of the Scapula with Screw Fixation for Fascioscapulohumeral Dystrophy (Modified Copeland-Howard Procedure)

“…It consists of subjective and objective measurements, and the total score is the sum of pain, activities of daily living, range of motion, and strength scores. In our study 15 , the total Constant score increased, on average, from 30 points (range, 17 to 41 points) preoperatively to 61 points (range, 30 to 90 points) postoperatively, whereas the Constant subscores increased from 9.8 points (range, 3 to 15 points) of 15 points preoperatively to 13.2 points (range, 8 to 15 points) postoperatively for pain, from 5.4 (range, 2 to 13) of 20 points to 14.6 points (range, 6 to 20 points) for activities of daily living, from 14.6 (range, 8 to 22) of 40 points to 25.6 points (range, 12 to 36 points) for range of motion, and from 0 of 25 points to 8 points (range, 0 to 20 points) for strength. There was a clear improvement in the ability to carry out daily and leisure activities as most of the patients went from having severe limitation to having moderate or less limitation.…”

“…Between July 1997 and July 2010, a thoracoscapular fusion was performed in thirty-five shoulders of twenty-four patients with fascioscapulohumeral dystrophy 15 . Eleven patients had a bilateral procedure.…”

Forequarter Replantation and the Lessons Learnt

“…We temporarily stabilized the acromioclavicular joint with a plate and planned to secondarily fix the scapula to the posterior chest wall with screws/wires. 8 We believe this to be the only practical option, although scapula-wall fixation might be attempted primarily if time permits. The second biggest challenge we faced was performing the anastomosis at depth in the axilla.…”