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