Shoulder Motion after Scapulothoracic Arthrodesis of the Facioscapulohumeral Type of Progressive Muscular Dystrophy ( PMD )

Lee, Yong Girl; Park, Gyoung Chean

Abstract

Many patients who have facioscapulohumeral muscular dystrophy eventually have instability of the scapula due to weakness of the muscles which stabilize the scapula. However, a subset of these patients have sufficient strength in the supraspinatus and deltoid muscle to abduct the arm if the scapula has been stabilized. In four patients who had facioscapulohumeral type of progressive muscular dystrophy, scapulothoracic arthrodesis was done for the treatment of limited unstable shoulder motion, especially flexion and abduction and symptomatic winging of the scapula caused by the loss of scapular stability from July 1994 to Feb.1995. The purpose of this study was to report 5 cases who obtained permanent stability after the scapulothoracic arthrodesis and compare the pre- and postoperative glenohumeral motion. The average preoperative active abduction was 74 degrees, which was improved to l35 degrees at the last follow up in 4 cases except unsatisfied 1 case. The average preoperative active flexion was 66 degrees, which improved to 140 degrees at last follow up. The average preoperative UCLA shoulder score was 18.4 points, which improved to 29.6 points at the last follow up. They were doing well in activity of daily living except unsatisfied one case. The scapulothoracic arthrodesis in the facioscapulohumeral type of the progressive muscular dystrophy is successful in achieving scapular stability so it is valuable for selected patients, as it improves appearance, enhances function, and increases tolerance to exercise.