Division of Arthroscopic, Reconstructive Surgery and Joint Preservation, UBC Department of Orthopedics, Burnaby, BC, Canada.
Charlotte Shoulder Institute, Gill Orthopaedic, Charlotte, NC, USA.
J Shoulder Elbow Surg. 2014 Apr;23(4):542-7. doi: 10.1016/j.jse.2013.08.009. Epub 2013 Nov 23.
Scapulothoracic fusion (STF) may be an option to alleviate pain and restore function. The purpose of this study is to report the clinical outcome of patients who underwent STF for the treatment of painful scapular winging.
From 1999 through 2008, 10 patients (12 shoulders) underwent an STF for painful winging of the scapula. The mean follow-up period was 41 months (range, 8-72 months). Indications for STF included winging in association with excessive medial and/or lateral clavicular resection and facioscapulohumeral dystrophy, as well as scapular winging related to combined long thoracic and spinal accessory nerve palsy. A retrospective review was performed to evaluate the subjective shoulder value, visual analog scale score, range of motion, unions, and complications.
There was a statistically significant improvement in the subjective shoulder value, visual analog scale score, range of motion, and satisfaction postoperatively. The overall complication rate was 50% (6 of 12). There were 2 persistent nonunions (2 of 12, 17%), and 50% (6 of 12) of all fusions required subsequent hardware removal because of discomfort. Complications included pleural effusion (3 of 12, 25%), hemopneumothorax (1 of 12, 8%) pulmonary embolus (1 of 12, 8%), and infection (1 of 12, 8%). With the exception of the revision nonunion, all complications resolved with no negative sequelae.
STF results in improved function and pain relief. STF is associated with a high short-term complication rate with limited long-term sequelae.
肩胛骨-胸壁融合术（STF）可能是缓解疼痛和恢复功能的一种选择。本研究旨在报告因肩胛骨翼状肩痛而行 STF 治疗的患者的临床结果。
1999 年至 2008 年，10 例（12 个肩）患者因肩胛骨翼状肩而行 STF。平均随访时间为 41 个月（范围，8-72 个月）。STF 的适应证包括与锁骨过度内侧和/或外侧切除以及面肩肱型肌营养不良症相关的翼状肩，以及与胸长神经和副神经联合损伤相关的肩胛骨翼状肩。对患者进行回顾性研究，评估主观肩部值、视觉模拟评分、活动范围、融合和并发症。
术后主观肩部值、视觉模拟评分、活动范围和满意度均有显著改善。总体并发症发生率为 50%（12 例中有 6 例）。有 2 例持续性不愈合（12 例中有 2 例，占 17%），12 例中有 50%（6 例）因不适而需要去除内固定物。并发症包括胸腔积液（12 例中有 3 例，占 25%）、血气胸（12 例中有 1 例，占 8%）、肺栓塞（12 例中有 1 例，占 8%）和感染（12 例中有 1 例，占 8%）。除了revision nonunion（翻修性骨不连）之外，所有并发症均得到解决，无不良后遗症。
STF 可改善功能和缓解疼痛。STF 短期并发症发生率较高，长期后遗症有限。
