“…Metal cables with buttress plates were used in 211 cases; these achieved fusion in 89.1% of cases ( Table II ). 2 , 3 , 22 , 23 , 27 , 28 , 29 , 33 , 5 , 8 , 11 , 12 , 13 , 15 , 16 , 17 Nineteen pneumothoraces have been reported with this construct type, 9% of all cases. Fifty-three reoperations were required, including 34 instances of painful or prominent hardware removal or trimming.…”
“…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%
“…The addition of iliac crest autograft or bone chip allograft contributes to successful fusion. 1 , 2 , 13 , 15 , 16 , 17 , 18 , 19 , 20 , 22 , 23 , 24 , 3 , 25 , 27 , 28 , 29 , 31 , 33 , 4 , 5 , 7 , 8 , 9 , 11 , 12 More recently, the introduction of ultra-high-molecular-weight polyethylene (UHMWPE)–reinforced suture has offered an alternative to traditional metal cables, having been shown to have greater strength than stainless steel as fracture tension bands. 6 , 32 Their use for the purposes of achieving a STF, however, is scarce, with only 3 reports describing 4 cases.…”
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.
“…Metal cables with buttress plates were used in 211 cases; these achieved fusion in 89.1% of cases ( Table II ). 2 , 3 , 22 , 23 , 27 , 28 , 29 , 33 , 5 , 8 , 11 , 12 , 13 , 15 , 16 , 17 Nineteen pneumothoraces have been reported with this construct type, 9% of all cases. Fifty-three reoperations were required, including 34 instances of painful or prominent hardware removal or trimming.…”
“…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%
“…The addition of iliac crest autograft or bone chip allograft contributes to successful fusion. 1 , 2 , 13 , 15 , 16 , 17 , 18 , 19 , 20 , 22 , 23 , 24 , 3 , 25 , 27 , 28 , 29 , 31 , 33 , 4 , 5 , 7 , 8 , 9 , 11 , 12 More recently, the introduction of ultra-high-molecular-weight polyethylene (UHMWPE)–reinforced suture has offered an alternative to traditional metal cables, having been shown to have greater strength than stainless steel as fracture tension bands. 6 , 32 Their use for the purposes of achieving a STF, however, is scarce, with only 3 reports describing 4 cases.…”
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.
“…b The humeral stem template can also provide additional information about location of proximal humerus osteotomy However, the literature does not report any of these techniques being used to alleviate scapulothoracic pain in patients with a fused shoulder. Although scapulothoracic fusions are used to relieve pain in this area, there is also no literature supporting this technique in the case of pain related to a fusion [2]. Sperling and Cofield [9] report a conversion of a shoulder arthrodesis to a total shoulder arthroplasty in three patients as an attempt to relieve severe pain in the scapulothoracic region.…”
There are several references in the hip and knee literature that mention converting fusions to a prosthetic total arthroplasty, but similar reports of total shoulder arthroplasty after glenohumeral fusion are lacking. The indication for conversion of a glenohumeral arthrodesis to a total shoulder arthroplasty is persistent periscapular pain refractory to conservative treatment. The purpose of the following article is to describe the preoperative plan and surgical technique in the conversion of a glenohumeral fusion to a total shoulder arthroplasty in single case of protracted scapulothoracic pain.
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