Scapulothoracic Arthrodesis: Indications and Surgical Technique

摘要

Scapulothoracic motion accounts for approximately one-third of total shoulder elevation. Disorders affecting the muscles that attach to the scapula coordinating scapulothoracic motion or injury to the nerves that innervate these muscles can result in winging of the scapula and subsequent scapular dyskinesis. Examples include facioscapu-lohumeral dystrophy (FSHD), neuralgic amoyotrophy, poliomyelitis, long thoracic nerve palsy (affecting serra-tus anterior), spinal accessory nerve palsy (affecting tra-pezius), and dorsal scapular nerve palsy (affecting rhomboids and levator scapulae). Loss of scapular stabilization results in an unstable base for efficient glenohum-eral motion, scapular winging, and subsequent loss of shoulder motion. Scapulothoracic arthrodesis provides rigid fixation of the scapula to the thorax, and long-term results of the procedure have generally been favorable. A surgical technique for scapulothoracic fusion and the results of the senior author's surgical experience are presented.