Scapulothoracic Arthrodesis in Facioscapulohumeral Muscular Dystrophy

Abstract

Avaliação dos resultados da artrodese da articulação escapulotorácica no tratamento da escápula alada na distrofia fascioescapulumeral 41 Rev Bras Ortop. 2008;43(1 / 2):41-7 Avaliação dos resultados da artrodese da articulação escapulotorácica no tratamento da escápula alada na distrofia fascioescapulumeral *

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

“…Intraoperative and postoperative complications such as pneumothorax, hemothorax, rib fracture, and scapular fracture have been reported 1,11,[13][14][15][16][17]19 . One patient (one shoulder) in the present series had a pneumothorax that was treated successfully by conservative means.…”

“…Surgical intervention in patients with facioscapulohumeral dystrophy typically consists of either thoracoscapular arthrodesis (scapulodesis) 1,[10][11][12][13][14][15][16][17][18][19][20] or thoracoscapular soft-tissue fixation without arthrodesis (scapulopexy) 4,21,22 (see Appendix). Arthrodesis of the scapula to the thoracic wall typically yields a solid fusion; however, there is concern regarding reduced respiratory function as well as the requirement for a prolonged period of postoperative immobilization that may result in muscle atrophy.…”

Fixation of Winged Scapula in Facioscapulohumeral Muscular Dystrophy

“…These methods include scapulothoracic fusion or arthrodesis (scapulodesis) 12,13,[17][18][19][20][21][22][23][24][25][26][27] and scapulothoracic fixation without arthrodesis (scapulopexy). 14,[28][29][30][31] Different techniques of scapulodesis have been reported using tibial cortical and cancellous bone graft and screws, 12 metal plates, 26,27 screws and cancellous bone graft, 25 and metal wires and bone graft, 22 with good clinical and functional results which have been maintained over a long period of time.…”

“…Surgical correction of winged scapula is the treatment of choice because it fixes the scapula permanently to the rib cage. 16 This fixation can be obtained by different techniques, which are grouped into scapulothoracic fusion or arthrodesis (scapulodesis) 12,13,[17][18][19][20][21][22][23][24][25][26][27] and scapulothoracic fixation without arthrodesis (scapulopexy). 14,[28][29][30][31] An alternative surgical technique of scapulopexy was described by Giannini et al in 1992.…”

Avaliação dos resultados da artrodese da articulação escapulotorácica no tratamento da escápula alada na distrofia fascioescapulumeral

“…Em alguns trabalhos os parâmetros mais utilizados foram flexão e abdução do ombro (1,3,8,(14)(15)(16) ; já outros consideraram a elevação, rotação lateral e medial como parâmetros para avaliação da mobilidade (4,12) .…”