title: Trapezius transfer to treat flail shoulder after brachial plexus palsy.
abstract: BACKGROUND
  After severe brachial palsy involving the shoulder, many different muscle transfers have been advocated to restore movement and stability of the shoulder. Paralysis of the deltoid and supraspinatus muscles can be treated by transfer of the trapezius.
  
  
  METHODS
  We treated 10 patients, 8 males and 2 females, by transfer of the trapezius to the proximal humerus. In 6 patients the C5 and C6 roots had been injured; in one C5, C6 and C7 roots; and 3 there were complete brachial plexus injuries. Eight of the 10 had had neurosurgical repairs before muscle transfer. Their average age was 28.3 years (range 17 to 41), the mean delay between injury and transfer was 3.1 years (range 14 months to 6.3 years) and the average follow-up was 17.5 months (range 6 to 52), reporting the clinical and radiological results. Evaluation included physical and radiographic examinations. A modification of Mayer's transfer of the trapezius muscle was performed. The principal goal of this work was to evaluate the results of the trapezius transfer for flail shoulder after brachial plexus injury.
  
  
  RESULTS
  All 10 patients had improved function with a decrease in instability of the shoulder. The average gain in shoulder abduction was 46.2 degrees; the gain in shoulder flexion average 37.4 degrees. All patients had stable shoulder (no subluxation of the humeral head on radiographs).
  
  
  CONCLUSIONS
  Trapezius transfer for a flail shoulder after brachial plexus palsy can provide satisfactory function and stability.
authors.affiliation: Manuel Fajardo Teaching Hospital, Orthopedics and Traumatology Department, Zapata y calle D, Vedado, CP:10400, Havana, Cuba. rjmg@infomed.sld.cu
authors.forename: Ricardo
authors.initials: R
authors.lastname: Monreal
authors.forename: Luis
authors.initials: L
authors.lastname: Paredes
authors.forename: Humberto
authors.initials: H
authors.lastname: Diaz
authors.forename: Pastor
authors.initials: P
authors.lastname: Leon