title: Restoring shoulder abduction in children with Erb's palsy: when to add trapezius transfer to a teres major transfer.
abstract: A total of 35 children with Erb's palsy and shoulder   abduction of < 90° underwent transfer of teres major. In 18 cases (group   1) a trapezius transfer was added (combined procedure). In 17 cases   (group 2) teres major transfer was carried out in isolation (single   procedure). The mean gain in abduction was 67.2° (60° to 80°) in   group 1 and 37.6° (20° to 70°) in group 2, which reached statistical   significance (p < 0.001). Group 2 was further divided into those who had deltoid power   of < M3 (group 2a) and those with deltoid power ≥ M3 (group 2b).   The difference in improvement of abduction between groups 2a and   group 2b was statistically significant (p < 0.001) but the difference   between group 2b and group 1 was not (p = 0.07). We recommend the following protocol of management: in children   with abduction ≥ 90° a single procedure is indicated. In children   with abduction < 90°: a combined procedure is indicated if deltoid   power is < M3 and a single procedure is indicated if deltoid   power is ≥ M3. If no satisfactory improvement is achieved, the trapezius   can be transferred at a later stage.
authors.affiliation: Faculty of Medicine, Ain Shams University, Department of Orthopaedics, Cairo 11588, Egypt. drtarekibrahim@hotmail.com
authors.forename: T H
authors.initials: TH
authors.lastname: Abdelaziz
authors.forename: S
authors.initials: S
authors.lastname: Samir
authors.forename: W
authors.initials: W
authors.lastname: Magdy
mesh_terms: D020516:Brachial Plexus Neuropathies / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012782:Shoulder / Q000601:surgery*; D013709:Tendon Transfer / Q000379:methods*; D016896:Treatment Outcome