Z Orthop Unfall 2018; 156(01): 53-61
DOI: 10.1055/s-0043-121699
Original article/Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Indication, Technique and Long-term Results after Shoulder Arthrodesis Performed with Plate Fixation

Article in several languages: English | deutsch
Ulrich Irlenbusch
Dept. shoulder surgery, sportklinik.ERFURT, Erfurt
Olaf Rott
Dept. shoulder surgery, sportklinik.ERFURT, Erfurt
Lars Irlenbusch
Dept. shoulder surgery, sportklinik.ERFURT, Erfurt
› Author Affiliations
Further Information

Publication History

Publication Date:
22 February 2018 (online)


Aim Arthrodesis of the shoulder joint is a radical event, so it is difficult to explain its significance to patients. It has been the last resort in hopeless cases. Knowledge of long-term results and evaluation of advantages and disadvantages seems to be helpful in this regard.

Methods Eleven patients with mean age of 45 (31 – 58) years were operated between 2000 and 2013. All patients could be included in the investigation (FU mean 8.5 [3 – 16] years; 8 male and 3 female; right 9, left 2). Patients had the following indications: persistent instability 5 (2 with epilepsy), rotator cuff rupture 2 (1× after combined latissimus dorsi and teres major transfer), brachial plexus injury/defect 2, locked dislocation 1 and posttraumatic arthropathy 1. Fixation with DC plate (pre-bent to 110°) was used in all cases; with special focus on placing at least one screw in the scapular neck. The targeted arthrodesis position was abduction 30°, forward flexion 30°, and internal rotation 30°.

Results Active abduction improved from 12 to 63°, forward flexion from 21 to 79° and internal rotation from 10 to 47° (mean values). In the resting position with hanging arm aside, mean abduction was 3° and forward flexion 8°. Nine of 11 patients had considerable relief of pain, from 8.3 to 2.4 points VAS. Five patients rated the outcome as excellent, 3 as good and 1 as satisfactory. Nine patients would repeat the procedure. In summary, an Oxford Shoulder Score of 31.6 points was achieved, and SSV of 58%. Bony fusion was achieved in all cases, 3 – 4 months p. o. in mean. There were no important neurological or angiological complications.

Conclusions Plate arthrodesis in the technique used achieves high fusion and a low complication rate. Relief of pain and functional improvement are astonishing. Analysis of our results indicates that correction of the positions mentioned above is necessary: i. o. arthrodesis position for abduction 25° (by means of pre-bending plate of 105°), forward flexion 20° and internal rotation 30° are suggested.

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