TITLE:
Transfer of the Trapezius to the Deltoid for Treatment of Shoulder Instability after Lesions of the Brachial Plexus
AUTHORS:
Antônio L. Severo, Philipe E. C. Maia, Marcelo B. Lemos, Paulo C. F. Piluski, Osvandré L. C. Lech, Walter Y. Fukushima
KEYWORDS:
Brachial Plexus Lesion; Shoulder Instability; Trapezius Transfer; Active Mobility; Shoulder Stability
JOURNAL NAME:
Surgical Science,
Vol.4 No.10,
October
30,
2013
ABSTRACT: Objective: To clarify the
indications and to describe the surgical technique and outcomes of surgery
involving transfer of the trapezius to the deltoid for the treatment of lesions
of the brachial plexus in patients with multidirectional instability in the
shoulder. Method: In 17 patients
(mean age, 23 years) operated at Sao Vicente de Paulo Hospital and the
Institute of Orthopedics and Traumatology of Passo Fundo, Brazil from1999
to 2009, we performed trapezius transfer to the proximal humerus. In these
patients, the mean interval between trauma and surgery was 8 months. Results: Functional improvement and
resolution of multidirectional instability of the shoulder were observed in all
the patients. No patient showed immediate postoperative complications. The mean
active mobility was as follows: 95° flexion,
50° abduction, 45° external
rotation, and internal rotation at the level of the first lumbar vertebra (L1).
The trapezius muscle strength was classified as grade III, and the UCLA
functional outcome was 22 points. The postoperative
satisfaction was excellent, and occasional pain and weakness was reported by
all the patients. Conclusions: Transfer
of the trapezius muscle to the proximal humerus provides better results in
patients with a more than 6-month-old lesion. This procedure also preserves passive
mobility of the limb, confers shoulder stability, provides active mobility, and
prevents osteoarthrosis.