2014
AUTHORSJean-Luc Jouve , Gerard Bollini , R. Legre , C. Guardia , E. Choufani , J. Demakakos , B. Blondel
ABSTRACTIn recent years, surgical indications for performing a shoulder arthrodesis have continuously decreased. Nowadays, such a procedure is reserved to specific pathological conditions like severe sequelae from brachial plexus palsy by Chammas et al. (J Bone Joint Surg Br 86(5):692–695, 2004), repeated failures after shoulder arthroplasty by Scalise et al. (J Bone Joint Surg Am 91(Suppl 2 Pt 1):30–7, 2009), high energy trauma with complex fractures or more frequently, malignant tumor of the humeral upper extremity by Viehweger et al. (Rev Chir Orthop Reparatrice Appar Mot 91(6):523–9, 2005). The main difficulty in shoulder arthrodesis is to obtain the best position for fusion in order to achieve the best functional outcome. While surfaces for fusion between the upper humeral extremity and the scapula are limited, a rigorous arthrodesis technique is necessary, especially when using a free vascularized transplant. In most of the cases, internal osteosynthesis will be necessary and pre-bent custom-made plates can therefore be very useful. Such devices will use the supraspinous fossa as the upper fixation and will give adequate angulation for management of fusion position in the coronal and sagittal planes however, control of the rotation remains the trickiest aspect of the procedure [Rühmann et al. (Orthopade 33(9):1061–80, 2004); Safran et al. (J Am Acad Orthop Surg 14(3):145–53, 2006)]. When following a strict and appropriate technique, shoulder arthrodesis leads to satisfactory functional outcomes in complex reconstruction procedures. This is particularly useful in situations where the rotator cuff and deltoid are inefficient, resulting in unsatisfactory outcomes of shoulder arthroplasty in these cases [Clare et al. (J Bone Joint Surg Am A(4):593–600, 2001; Cofield et al. (J Bone Joint Surg Am 61(5):668–77, 1979]. More... »
PAGES1201-1215
European Surgical Orthopaedics and Traumatology
ISBN
978-3-642-34745-0
978-3-642-34746-7
http://scigraph.springernature.com/pub.10.1007/978-3-642-34746-7_234
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