Glenohumeral Arthrodesis Using Pelvic Reconstruction Plates: a Series of 15 Patients.

BACKGROUND: Glenohumeral joint arthrodesis has become a rare entity due to the introduction of shoulder arthroplasty. It is an excellent salvage procedure for patients with severe shoulder dysfunction, with limited treatment options, indicated for brachial plexus injury, tumour resection, chronic infection, failed prosthetic arthroplasty, or pseudoparalysis of the shoulder due to combined rotator cuff and deltoid deficiency. Shoulder arthrodesis relieves the patient of pain and gives a decent amount of function. The aim of this study was to examine the mid-term outcomes of glenohumeral arthrodesis with 2 pelvic recon plates. METHODS AND METHODS: This study was done in a tertiary referral centre over a period of about 2 years. All the patients were operated on with 2AO 3.5mm recon plates and screws. Indications for surgery comprised unreconstructable rotator cuff tears, a neoplastic lesion, paralytic disorders, TB shoulder, arthritic disease unsuitable for arthroplasty, and sequelae of septic shoulder. Cancellous grafts were used in all operated patients, while a cortical graft was used in the tumour case to fill the bone defect after tumour excision. A minimum of 18 months was essential for inclusion into the study. RESULTS: 15 patients were included in the study. All the patients had decreased postoperative pain, which further decreased to pain-free status at further follow-up visits. All the arthrodeses produced bony union with average time to union of 5.4 months. All patients could feed and dress themselves with the ipsilateral limb. The only complication noted in this series was a superficial infection in 3 patients only, which subsided after wound wash, debridement and antibiotics for 10 days. CONCLUSIONS: 1. With specific indications, shoulder arthrodesis results in a good painless postoperative shoulder function and thus presents an excellent operative option. 2. The position of arthrodesis chosen here ensures that the arm rests comfortably at the side. 3. The patients can move their hands to their mouth and facial regions. 4. Recon plates should be used for arthrodesis because they are easy to shape without compromising on strength. 5. Few complications of procedure are there but it is a great therapeutic measure in selected individuals.

Osteotomy and Re-fixation for treatment of Malunited Greater Tuberosity of Humerus.

INTRODUCTION: Most greater tuberosity humerus fractures can be treated successfully with either surgical or conservative methods and good results can be expected if fracture heals anatomically but a displaced fracture or an improperly reduced fracture can lead to a symptomatic mal-union. CASE PRESENTATION: 36years old man with mal-united greater tuberosity fracture presented to us 18 months following injury and percutaneous screw fixation and 9 months after screw removal. She complained of severe restriction of shoulder movements. A good result was achieved after corrective open reduction and fixation of the greater tuberosity and rotator cuff repair. CONCLUSION: Open reduction, re-fixation and soft tissue reconstruction can give excellent results in cases of malunited greater tuberosity fractures even as late as 20 months after trauma.