Scapulocostal stabilization for scapular winging in facioscapulohumeral muscular dystrophy.

A surgical procedure has been devised to prevent scapular winging and to increase shoulder abduction in facioscapulohumeral muscular dystrophy. The operation improves the limited shoulder abduction and scapular winging caused by the loss of scapular fixation to the thoracic cage, while passive abduction at the glenohumeral joint remains normal. Preventing scapular malrotation by eliminating scapulothoracic motion increases shoulder abduction. This is achieved by fastening the scapula to several underlying ribs with fascia. The operation has resulted in a 37 per cent increase in abduction, increased shoulder strength and endurance, and the prevention of scapular winging.