Shoulder fusion for paralyzed upper limb.

Fusion of the shoulder joint after a brachial plexus injury is a well known procedure in cases of flail shoulder in combination with normal motor and sensory function in the band. However, in combination with modern orthoses to stabilize the elbow, fusion of the shoulder in cases of a totally flaccid and afunctional arm might be more beneficial. In a retrospective study the impact of shoulder fusion on daily abilities in a population with a completely flaccid arm caused by a brachial plexus injury was investigated. Compared with a similar population, consisting of 16 patients with an afunctional unstable shoulder, all 12 patients who underwent shoulder fusion proved to perform at a higher functional level. Shoulder fusion in combination with an elbow stabilizing orthosis for a completely flaccid upper limb is a beneficial procedure that leads to less disability and results in a better quality of life.