Scapulothoracic Fusion

Abstract

Scapular winging can result from multiple dystrophic and nondystrophic etiologies. These conditions lead to alteration in the kinematics of the shoulder with subsequent pain, loss of motion, and an unacceptable cosmetic appearance. This leads to an articulation that does not align with the chest wall. An understanding of the multiple causes of scapular winging is important for determining the appropriate treatment. Scapulothoracic fusion is a salvage procedure designed to alleviate the pain and chronic disability associated with scapular winging. The procedure is an option in patients who are refractory to nonsurgical management or when muscle transfer is not indicated. Following successful fusion, the cosmesis and function of the shoulder are improved, and pain is subsequently decreased. Scapulothoracic fusion is a technically demanding procedure that requires a thorough knowledge of the periscapular anatomy. Attention to a meticulous surgical technique promotes a solid fusion while minimizing complications.

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