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Anatomo-experimental study for lace fixation of winged scapula in muscular dystrophy

Etude anatomique expérimentale de la fixation par laçage de la scapula décollée dans les dystrophies musculaires

  • Anatomic Bases Of Medical, Radiological And Surgical Techniques
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Summary

Winging of the scapula is one of the major features of the rare facio-scapulo-humeral muscular dystrophy. Several methods of retention and fixation of the scapulae have been published, but most have technical disadvantages or complications. A modified method of operative fixation of the scapula to the chest using three polyester laces is described with the results of cadaveric studies on the stability of this system. In order to determine the optimal region for the scapula fixation using polyester laces we performed pull-out tests on twenty cadaver scapulae. Four points of insertion in the inferior part of the scapula were tested. The lateral margin showed the best results with regard to the tensile strength and the morphology of the resulting fractures. The elongation of the laces was measured as well. Compared to scapulothoracic arthrodesis interscapulo-scapulocostal scapulopexy leads to greater preserved mobility between the scapula and the chest wall and conserves vital capacity.

Résumé

Le décollement de la scapula est une des complications importantes de la dystrophie musculaire facio-scapulo-humérale. Plusieurs méthodes de correction et de fixation de la scapula ont été publiées mais la plupart présente des inconvénients et des complications. Une nouvelle méthode de fixation scapulaire sur le thorax est décrite à l'aide de trois lacets en polyester. Les résultats sur la stabilité de ce système étudié chez le cadavre sont décrits. Afin de préciser les meilleurs sites des points de fixation, nous avons effectué des tests d'arrachage chez 20 cadavres. Quatre points d'insertion à la partie inférieure de la scapula ont été testés. Le bord latéral offrait les meilleurs résultats eu égard à la résistance et à la solidité. L'étirement des lacets a été mesuré. Comparée à l'arthrodèse inter-scapulo-thoracique, la scapulopexie permet de conserver une meilleure mobilité entre la scapula et le thorax, et de maintenir une capacité respiratoire vitale optimale.

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Authors and Affiliations

  1. Orthopaedic Department, Medical Faculty, RWTH Aachen, Pauwelsstrasse 30, D-52074, Aachen, Germany

    K -D Heller, J Forst, A Stadtmüller & R Forst

  2. Anatomical Institute I, Medical Faculty, RWTH Aachen, Wendlingweg 2, D-52074, Aachen, Germany

    A Prescher

Authors
  1. K -D Heller
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  2. A Prescher
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  3. J Forst
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  4. A Stadtmüller
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  5. R Forst
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Heller, K.D., Prescher, A., Forst, J. et al. Anatomo-experimental study for lace fixation of winged scapula in muscular dystrophy. Surg Radiol Anat 18, 75–79 (1996). https://doi.org/10.1007/BF01795222

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  • DOI: https://doi.org/10.1007/BF01795222

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