title: Scapulothoracic fusion: outcomes and complications.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  STF results in improved function and pain relief. STF is associated with a high short-term complication rate with limited long-term sequelae.
authors.affiliation: Division of Arthroscopic, Reconstructive Surgery and Joint Preservation, UBC Department of Orthopedics, Burnaby, BC, Canada.
authors.forename: Danny P
authors.initials: DP
authors.lastname: Goel
authors.affiliation: Charlotte Shoulder Institute, Gill Orthopaedic, Charlotte, NC, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Romanowski
authors.affiliation: Harvard Shoulder Service, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Lewis L
authors.initials: LL
authors.lastname: Shi
authors.affiliation: Harvard Shoulder Service, Massachusetts General Hospital, Boston, MA, USA. Electronic address: jwarner@partners.org.
authors.forename: Jon J P
authors.initials: JJ
authors.lastname: Warner
mesh_terms: D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012272:Ribs / Q000601:surgery*; D012540:Scapula / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult
keywords: Scapulothoracic fusion; complications; facioscapulohumeral dystrophy; scapular winging