We report our results and technique of scapulothoracic fusion. 14 fusions were performed in 10 patients between 2001 and 2005. The underlying diagnosis was fascioscapulohumeral dystrophy in 7 patients (11 cases). The diagnosis in the remaining three patients was failure of scapular suspension due to C4/5 tetraplegia, stroke and cerebral palsy. There were five women and five men with an average age of 35.4 years (range 15–75) In each case the medial scapular border was wired to the ribs with the support of a one-third semi-tubular plate and autologous bone graft. We compared pre and post-operative active forward flexion and abduction. Satisfaction with the procedure was also rated. There was no need for single-lung ventilation or a chest drain and there were no significant post-operative complications. There were two cases of non-union. One patient, a heavy smoker, travelled abroad and has been lost to follow-up, the other aged 76 is awaiting revision surgery. The mean range of preoperative active forward flexion and abduction were 71° (range 30–90°) and 58° (range 40–90°) respectively. The mean post-operative values were 96° (90–120°) and 94° (80–120°) respectively. The remaining 8 patients were enthusiastic or satisfied with the result of the operation. This technique was very successful in 12 out of our 14 cases (85.7%) and is to be recommended. However, union may be unpredictable in older patients

Scapular instability is a disabling deformity that results in pain and influences the overall upper limb function ; for which scapular stabilization may be necessary. Aim: To review the results of this procedure. Methods: 9 patients who underwent this procedure could be contacted and were assessed. We used the Disability of Arm, shoulder and Hand score(DASH) and the constant score for shoulder function including subjective assessment of patients pain and overall satisfaction and radiographs for evidence of unionwith a mean age of 36 yrs(range 21–57 yrs), performed in the period between July 1996 and October 2002 with a mean follow up period of 35.7 months,(range 10–72 months).6 of them were primary procedures and two were revisions for failed primary stabilisation . The main pre-operative complaint of these patients was dragging pain, scapular winging, painful forward flexion and abduction and sense of instability. The underlying pathology was Fascio-scapulo-humeral dystrophy in 3, sprengels shoulder in 2,brachial plexus palsy in 1, following trapezius muscle excision in 1, residual winging following shoulder fusion in 1. The technique used for fusion was plate and wires in 6, Rush pin and wires in 2. All of them had bone grafting . At the last follow up the mean DASH score was 37 and the mean constant score was 74.67. All patients had mild or no pain,felt their scapula stable and were satisfied with the outcome. The main post operative complaint was wire breakage and migration that necessitated removal in 3 patients. We conclude that scapulothoracic fusion is a valuable procedure and can restore reasonable shoulder function and relieve pain in patients with scapular instability