Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 24601
FUNCTIONAL OUTCOME OF SCAPULOTHORACIC FUSION FOR
FASCIOSCAPULOHUMERAL DYSTROPHY
Inder GILL, Brendan FOURIE, Paul STUART
Freeman Hospital, Newcastle Upon Tyne (UNITED KINGDOM)
AIM: To assess the functional outcome and influence on lung function of
Scapulothoracic fusion in patients with Fascioscapulohumeral Dystrophy (FSHD).
MATERIAL AND METHODS: All patients undergoing Scapulothoracic fusion for
FSHD were prospectively studied. There were 10 fusions in 9 patients. All had
significant deficit in shoulder function. The scapula was fused to the ribs using 2 rows
of circlage wires tightened over longitudinal reconstruction plates augmented by fresh
frozen allograft. Preo and postoperative Lung function (LFT) and Disabilities of Arm,
Shoulder and Hand(DASH) scores were recorded. Active shoulder elevation was
also assessed. RESULTS: There were 9 patients, 4 males and 5 females (one had
staged bilateral procedures). The average follow was 29 months (Range 12-50
months). The forward elevation improved from a mean of 70 degrees to 115 degrees.
The mean Forced vital capacity (FVC) reduced to 4.29 litres (2.4 - 5.8) from 4.6 Litres
(3.1 - 6.4) preoperatively. This difference was not significant. The mean DASH score
preoperatively was 49.96(31.66 – 74.16). This reduced postoperatively to 38.58(9.17
– 70). This difference was significant (p-0.05).5 patients needed removal of implants.
1 patient needed revision of fusion for non-union. 1 patient had postoperative
transient intercostal neuralgia and another developed postoperative chest infection.
CONCLUSIONS: Scapulothoracic fusion gave good functional results in our small
study group with improvement in DASH scores and forward elevation. This is not an
operation without complications but functional gain without significant loss of lung
function is achieved.
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