ANATOMO-EXPERIMENTAL STUDY FOR LACE FIXATION OF WINGED SCAPULA IN MUSCULAR-DYSTROPHY

Winging of the scapula is one of the major features of the rare facio- scapulo-humeral muscular dystrophy. Several methods of retention and f ixation of the scapulae have been published, but most have technical d isadvantages or complications. A modified method of operative fixation of the scapula to the chest using three polyester laces is described with the results of cadaveric studies on the stability of this system. In order to determine the optimal region for the scapula fixation usi ng polyester laces we performed pull-out tests on twenty cadaver scapu lae. Four points of insertion in the inferior part of the scapula were tested. The lateral margin showed the best results with regard to the tensile strength and the morphology of the resulting fractures. The e longation of the laces was measured as well. Compared to scapulothorac ic arthrodesis interscapulo-scapulocostal scapulopexy leads to greater preserved mobility between the scapula and the chest wall and conserv es vital capacity.