Aims

This phase II safety study aimed to investigate the bleeding side effect profile in patients treated with Rivaroxaban as a new agent for venous thromboembolism (VTE) prophylaxis following hip or knee arthroplasty.

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.