JBJS | Scapulothoracic Fusion for Clavicular Insufficiency: A Report of Two Cases

The Journal of Bone & Joint Surgery, Volume 90, Issue 4

Case Reports | April 01, 2008

Scapulothoracic Fusion for Clavicular Insufficiency: A Report of Two Cases

Bassem Elhassan, MD¹; Soo Tai Chung, MD¹; Mehmet Ozbaydar, MD¹; David Diller, BA¹; Jon J.P. Warner, MD¹

¹ Division of Shoulder Surgery, Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail address for B. Elhassan: belhassan@partners.org. E-mail address for B. Elhassan: belhassan@partners.org. E-mail address for S.T. Chung: schung@partners.org. E-mail address for M. Ozbaydar: mozbaydar@partners.org. E-mail address for D. Diller: ddiller@partners.org. E-mail address for J.J.P. Warner: JWarner@partners.org

The Journal of Bone & Joint Surgery. 2008; 90:875-880 doi:10.2106/JBJS.G.00986

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Extract

Scapulothoracic fusion is an uncommon procedure performed to stabilize the scapula to the chest wall. It is usually used to treat painful refractory winging of the scapula^1-4, and it has been described principally in patients with fascioscapulohumeral muscular dystrophy, since tendon transfers in this population are usually unsuccessful^2-8. Other indications include salvage of failed tendon transfer procedures to treat spinal accessory nerve palsy^1,9,10 or long thoracic nerve palsy^3,9-12. Additionally, disabling scapular winging secondary to loss of the medial clavicular strut support is a very rare indication that has not been reported previously. We report our experience with two patients in whom excision of the medial portion of the clavicle resulted in subsequent loss of scapular control and severe pain. Both patients were successfully managed with scapulothoracic fusion.

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Topics

clavicle ; scapulothoracic fusion ; pain ; shoulder region ; scapula ; arm

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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