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Scapulothoracic Arthrodesis in Facioscapulohumeral Dystrophy with Multifilament Cable

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Clinical Orthopaedics and Related Research®

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 47.2° ± 11.6° to 102.2° ± 10.0° (mean ± standard deviation) and anterior flexion range from 55.6° ± 16.1° to 126.1° ± 20.9°. The DASH score decreased from 33.6 ± 8.9 points preoperatively to 11.6 ± 8.0 points postoperatively. Shoulder function score increased from 15.9 ± 2.4 points to 22.2 ± 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.

Level of Evidence: Level IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Professor Yesim Parman, Professor Feza Degmeer, and Selin Yilmazer, MD from the FSHD study group of Istanbul University, Istanbul Medical Faculty, for their valuable contributions. We also appreciate the assistance of Kevin Flanigan, MD from the Department of Neurology, University of Utah, Salt Lake City, UT, USA, for the genetic tests of our patients; and Mehmet Calay, MD, from Istanbul University, who interpreted the 3-D CT images of our patient group.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, Istanbul Medical Faculty, Istanbul University, 34093, Istanbul, Turkey

    Mehmet Demirhan MD, Ozgur Uysal MD, Ata Can Atalar MD & Onder Kilicoglu MD, PhD

  2. Department of Neurology, Neuromuscular Unit, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey

    Piraye Serdaroglu MD

Authors
  1. Mehmet Demirhan MD
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  2. Ozgur Uysal MD
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  3. Ata Can Atalar MD
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  4. Onder Kilicoglu MD, PhD
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  5. Piraye Serdaroglu MD
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Correspondence to Ata Can Atalar MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research.

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Demirhan, M., Uysal, O., Atalar, A.C. et al. Scapulothoracic Arthrodesis in Facioscapulohumeral Dystrophy with Multifilament Cable. Clin Orthop Relat Res 467, 2090–2097 (2009). https://doi.org/10.1007/s11999-009-0815-9

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  • DOI: https://doi.org/10.1007/s11999-009-0815-9

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