Shoulder Arthrodesis in Pediatric Patients

The role of shoulder fusion in the era of arthroplasty

“…Pruitt et al reported 17 patients with 91% satisfactory results and recommended the ideal position as abduction 50°+7°, forward flexion 26°+7°and rotation between 20°external and 30°i nternal [17]. They concluded that the angles were not critical, but hyperabduction, which gave the worst results, and excessive flexion should be avoided.…”

“…In children, there is a risk of epiphyseal damage which will impair fusion [7]. The abducted position may decrease with growth [14] with the possibility to a very short upper limb [17].…”

Primary stability of shoulder arthrodesis using cannulated cancellous screws

“…Few details are given about the screws used and their position. 1,7,15,[17][18][19]21,30,31 Various cancellous bone screws and/or cortical screws are used in a number of different positions. The number of humerus-glenoid screws used and the total number of screws vary from 0 to 4, and the number of acromion-humerus screws varies from 0 to 2.…”

“…† Some authors also use an external fixator. 4,10,19,21 When the developmental mechanism of nonunion is under consideration, factors such as excessive mobility (instability), absence of fragment contact, and impairment to the periosteal blood flow may be positively influenced by the method of surgical intervention by use of rigid fixation and a limited amount of osteosynthesis material. The rate of infection is likely to be minimized by shortening the time required for operation and reducing soft-tissue and bone necrosis arising through surgical intervention.…”

Shoulder arthrodesis: Indications, technique, results, and complications

“…9 Other reports on reoperations concern the removal of material for persistent pain 1,3,5,31,43,44,45,57 or breakage of implants. 35,40 The listed complications found in the literature correspond to a total of 28% (Table I). † Cofield and Briggs 11 reported on the largest number of cases of shoulder arthrodesis.…”