Authors:
Address: Department of Orthopedics and Traumatology, Okmeydanı Training and Research Hospital, İstanbul, Turkey. esenyel@yahoo.com
Journal:

Publication:

abstract

OBJECTIVE:

The aim of this study was to evaluate the long-term outcome of shoulder arthrodesis with plate fixation and primary autogenous grafting in terms of pain, functional status and arthrodesis position.

METHODS:

The study included 8 patients (7 males and 1 female; mean age: 39.3 years; range: 22 to 68 years) who underwent arthrodesis with plate fixation and primary autogenous grafting. Mean follow-up period was 66.6 (range: 47 to 96) months. Five cases had traumatic brachial plexus palsy, 2 polio sequela and 1 sequela of an operated proximal humerus fracture due to a falling injury. One of the traumatic palsy cases was accompanied with a humerus shaft fracture. Arthrodesis was performed in all cases according to AO principles with plate fixation and primary autogenous grafting. Five of the paralytic patients also underwent Steindler flexorplasty. Follow-up assessments included monthly radiologic control for union, the visual analog scale (VAS) for pain and the Oxford shoulder score (OSS) for functional status.

RESULTS:

Radiological fusion was seen in all cases in an average of 16 (range: 12 to 18) weeks, and arthrodesis was stable at physical examination. The accompanying humerus shaft fracture was also fixed with plate. One patient with traumatic palsy experienced a humerus fracture distal to the arthrodesis plate at the 8th postoperative month. An additional traumatic palsy case had flexion deformity at the wrist in the second year of follow-up and a wrist arthrodesis with dorsal plate was performed. One patient (12.5%) had a donor site infection on the tenth day after surgery. The target positions of 30° of abduction, 30° of forward flexion, and 30° of internal rotation were achieved with an average deviation of 7°. Mean active abduction was 68.1° (range: 55° to 90°), flexion was 67.5° (range: 60° to 85°), and internal rotation was at the level of trochanter major. The mean OSS was 35.9 (range: 32 to 40), and the mean VAS score was 2.9 (range: 1 to 7).

CONCLUSION:

Our findings show that AO reconstruction plate and primary autogenous bone grafting is a safe and effective arthrodesis method that can also be used as a salvage procedure.

Related Articles
[Arthrodesis of the shoulder for post-traumatic palsy of the brachial plexus. Analysis of a series of 18 cases].
Rev Chir Orthop Reparatrice Ap...
[Arthrodesis of the shoulder for post-traumatic palsy of the brachial plexus. Analysis of a series of 18 cases].
Chammas M, Meyer zu Reckendorf G, Allieu Y. Rev Chir Orthop Reparatrice Appar Mot. 1996; 82(5):386-95.
Shoulder arthrodesis in brachial plexus injuries--a review of six cases.
Med J Malaysia. 2005
Shoulder arthrodesis in brachial plexus injuries--a review of six cases.
Wong EL, Kwan MK, Loh WY, Ahmad TS. Med J Malaysia. 2005 Jul; 60 Suppl C:72-7.
Shoulder arthrodesis for the treatment of brachial plexus palsy.
Clin Orthop Relat Res. 1985
Shoulder arthrodesis for the treatment of brachial plexus palsy.
Richards RR, Waddell JP, Hudson AR. Clin Orthop Relat Res. 1985 Sep; (198):250-8.
Review Shoulder arthrodesis.
J Bone Joint Surg Am. 2001
Review Shoulder arthrodesis.
Clare DJ, Wirth MA, Groh GI, Rockwood CA Jr. J Bone Joint Surg Am. 2001 Apr; 83-A(4):593-600.
Review [Arthrodesis of the shoulder in paralysis of the brachial plexus. Apropos of 2 cases].
Rev Chir Orthop Reparatrice Ap...
Review [Arthrodesis of the shoulder in paralysis of the brachial plexus. Apropos of 2 cases].
Ducloyer P, Nizard R, Sedel L, Witvoët J. Rev Chir Orthop Reparatrice Appar Mot. 1991; 77(6):396-405.

To top • Home

---

Show map | Diseases | Vaccination | Chronic disease | Medicine | Pregnancy | Heat & Sunburn | Cold | Security | Useful tips | Faq | News

TraveldoctorOnline 2001 • Disclaimer • webmaster