A detachment of the shoulder blades of varying importance is present in many neuromuscular diseases. Linked to weakness in the muscles fixing shoulder blades, the phenomenon is the cause of disfigurement, sometimes major functional discomfort and, sometimes, painful phenomena. This is especially true in facio-scapulo-humeral myopathy (FSH) where this detachment is constant and very pronounced. A scapulothoracic arthrodesis can be proposed when functional discomfort and / or pain is particularly important.
In an article published in April 2020, Canadian clinicians reviewed all the studies available to date on this topic. Thirteen of them involved 130 patients with FSH, corresponding to a total of 199 surgical procedures. The functional results are generally very encouraging with, at the end of this surgery, an average gain in shoulder antepulsion of 45 degrees and abduction of 40 degrees, all to the great satisfaction of the patients. Even if the data are fragmented, it does not seem to be any significant long-term impact on respiratory function. On the other hand, the authors insist on significant operative and post-operative complications (disunity of the assembly, breakage of osteosynthesis material, pneumothorax, transient nerve compressions) since occurring in 41% of cases. Despite all of this and a methodological bias linked to the diversity of the surgical techniques used, the authors have a positive judgment on this procedure.
