Article

Abstract : Long-term results of Letournel scapulo thoracic fusion in facio scapulohumeral
muscular dystrophyThe aim of this study was to evaluate long-term radio-clinical
outcome in scapulothoracic fusion using the Letournel technique (where the fourth
rib is passed through the wing of the scapula and cerclage wires are tightened to
the two ribs below) for patients suffering from facioscapulohumeral muscular
dystrophy (FSHMD), a degenerative pathology affecting scapula-stabilizing
muscles, leading to scapular winging, shoulder pain and restricted shoulder
abduction and flexion, despite a functional deltoid muscle. METHODS: This
retrospective study, with an average follow-up of 14 years (168 months; sigma=73
months), included four patients who underwent a bilateral procedure, one side
after the other, with shoulder abduction and flexion gain as primary endpoints.
RESULTS: Mean improvement in range of motion was 36 degrees (sigma=32 degrees )
in abduction and 40 degrees (sigma=44 degrees ) in flexion. Postoperatively,
active abduction averaged 99 degrees (sigma=28 degrees ) and active flexion 110
degrees (sigma=45 degrees ). In one case, a 58 year-old patient, gain in motion
was 50 degrees for abduction and 60 degrees for anterior elevation. In one
patient, range of motion showed bilateral decrease due to the natural course of
the FSHMD. No intraoperative complications were reported. DISCUSSION: The
Letournel technique seems to be an effective long-term solution in FSHMD, without
age limit. Improvements appear to be steady over time, the only long-term
limitations being the natural course of the disease itself. LEVEL OF EVIDENCE: IV
- retrospective case series.
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Langue : FRANCAIS