Prolonged exposure to potentially damaging noise levels in the workplace has been the subject of much recent litigation. The occupational risk of noise induced hearing loss among orthopaedic surgeons is unknown. Continuous readings of air-powered instruments routinely used in orthopaedic surgery were made in a regional trauma unit at standard distance from the noise source. All instruments generated noise levels greater than the threshold for routine monitoring of hearing loss under health and safety legislation.

Case: A 32-year-old male right-hand dominant school-bus driver with facioscapulohumeral dystrophy (FSHD) was referred to an upper limb specialist for consideration for scapulothoracic fusion (STF) because of limited upper limb function and cosmetic issues. Staged bilateral STFs were performed with seven high-strength suture tapes tensioned to secure a standard tubular plate in situ. Conclusion: STF may be a desirable treatment option for patients with FSHD. The use of high-strength suture tapes in cases of STF allows for secure fixation of the scapulothoracic joint. This potentially confers a reduction in operative time while ensuring adequate tensioned fixation and minimizing the risk of iatrogenic pneumothorax.

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