Scapulothoracic Arthrodesis in Facioscapulohumeral Dystrophy with Multifilament Cable

Abstract

Patients with facioscapulohumeral dystrophy (FSHD) are affected mostly by impaired shoulder function. Scapulothoracic arthrodesis was introduced to improve shoulder function. We evaluated the outcomes of scapulothoracic arthrodesis using multifilament cables, performed on 13 patients with FSHD (18 shoulders). There were eight males and five females (mean age, 29 years; range, 20-50 years). Outcome criteria were active shoulder forward flexion and abduction, the Disabilities of the Arm, Shoulder, and Hand (DASH) score, respiratory function tests, and a new shoulder function score. Patients were followed for a minimum of 24 months (average, 35.5 months; range, 24-87 months). Solid fusion was obtained in all shoulders (two after revision); active abduction range increased from 47.2A degrees A A +/- A 11.6A degrees to 102.2A degrees A A +/- A 10.0A degrees (mean +/- A standard deviation) and anterior flexion range from 55.6A degrees A A +/- A 16.1A degrees to 126.1A degrees A A +/- A 20.9A degrees. The DASH score decreased from 33.6 +/- A 8.9 points preoperatively to 11.6 +/- A 8.0 points postoperatively. Shoulder function score increased from 15.9 +/- A 2.4 points to 22.2 +/- A 1.3 points. Scapulothoracic arthrodesis provides satisfactory function in patients with FSHD. Our data suggest use of multifilament cables for fixation is a reasonable option with an acceptable complication rate.