Demirhan Mehmet, Uysal Ozgur, Atalar Ata Can, Kilicoglu Onder, Serdaroglu Piraye
Department of Orthopaedics and Traumatology, Istanbul Medical Faculty, Istanbul University, 34093, Istanbul, Turkey.
Clin Orthop Relat Res. 2009 Aug;467(8):2090-7. doi: 10.1007/s11999-009-0815-9. Epub 2009 Mar 31.
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 degrees +/- 11.6 degrees to 102.2 degrees +/- 10.0 degrees (mean +/- standard deviation) and anterior flexion range from 55.6 degrees +/- 16.1 degrees to 126.1 degrees +/- 20.9 degrees . 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 IV, case series. See the Guidelines for Authors for a complete description of levels of evidence.
面肩肱型肌营养不良症（FSHD）患者主要受肩部功能受损影响。肩胛胸壁关节融合术被引入以改善肩部功能。我们评估了对13例FSHD患者（18个肩部）实施的使用多股缆线的肩胛胸壁关节融合术的结果。其中男性8例，女性5例（平均年龄29岁；范围20 - 50岁）。结果标准包括肩部主动前屈和外展、手臂、肩部和手部功能障碍（DASH）评分、呼吸功能测试以及一项新的肩部功能评分。患者随访至少24个月（平均35.5个月；范围24 - 87个月）。所有肩部均实现牢固融合（2例翻修后）；主动外展范围从47.2度±11.6度增加到102.2度±10.0度（均值±标准差），前屈范围从55.6度±16.1度增加到126.1度±20.9度。DASH评分从术前的33.6±8.9分降至术后的11.6±8.0分。肩部功能评分从15.9±2.4分提高到22.2±1.3分。肩胛胸壁关节融合术为FSHD患者提供了满意的功能。我们的数据表明使用多股缆线进行固定是一种并发症发生率可接受的合理选择。
IV级，病例系列。有关证据级别的完整描述，请参阅作者指南。
