title: Arthroscopic arthrodesis of the shoulder in brachial plexus palsy.
abstract: BACKGROUND
  Shoulder arthroscopic arthrodesis is an uncommon and non-standardized procedure. Results are poorly evaluated. We describe the findings in 8 patients who underwent shoulder arthroscopic arthrodesis for brachial plexus injury.
  
  
  METHODS
  The humeral head and glenoid were excised through standard arthroscopic portals. A Hoffmann external fixator and cannulated screws were used to stabilize the shoulder. Standard clinical assessment and radiographic evaluation were performed each month until bony fusion occurred. With a mean follow-up of 28 months, functional evaluation included pain level (on a 0- to 10-mm visual analog scale); American Shoulder and Elbow Surgeons index; Disabilities of the Arm, Shoulder and Hand score; and Simple Shoulder Test score. Mobility was systematically investigated. Blood loss was assessed by measuring hematocrit proportion.
  
  
  RESULTS
  Glenohumeral fusion was achieved in all 8 patients. The mean time to arthrodesis was 3 months (range, 2-8 months). At last follow-up, the mean pain level was 1 (range, 0-4); the mean American Shoulder and Elbow Surgeons score was 69; the mean Disabilities of the Arm, Shoulder and Hand score was 36; and the mean Simple Shoulder Test score was 4. Mean active flexion and abduction were 80° (range, 60°-90°) and 59° (range, 40°-80°), respectively. Mean blood loss during the perioperative period was 432 mL (range, 246-792 mL). We observed one superficial wound infection and one migration of an acromiohumeral screw. These complications did not compromise the final results.
  
  
  CONCLUSIONS
  Arthroscopic arthrodesis of the shoulder can be a reliable procedure and associated with a low rate of complications.
authors.affiliation: Centre Ostéo-Articulaire des Cèdres, Échirolles, France. Electronic address: hubert.lenoir@laposte.net.
authors.forename: Hubert
authors.initials: H
authors.lastname: Lenoir
authors.affiliation: Hand Surgery Unit, Orthopedic Surgery Department, CHU La Cavale Blanche, Brest, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Williams
authors.affiliation: Hand Surgery Unit, Orthopedic Surgery Department, CHU La Cavale Blanche, Brest, France.
authors.forename: Aude
authors.initials: A
authors.lastname: Griffart
authors.affiliation: Hand and Upper Extremity Surgery Unit, CHU Lapeyronie, Montpellier, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Lazerges
authors.affiliation: Hand and Upper Extremity Surgery Unit, CHU Lapeyronie, Montpellier, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Chammas
authors.affiliation: Hand and Upper Extremity Surgery Unit, CHU Lapeyronie, Montpellier, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Coulet
authors.affiliation: Hand and Upper Extremity Surgery Unit, CHU Lapeyronie, Montpellier, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Le Nen
mesh_terms: D000328:Adult; D001174:Arthrodesis; D001182:Arthroscopy; D001863:Bone Screws; D001917:Brachial Plexus / Q000293:injuries*; D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D015331:Cohort Studies; D016267:External Fixators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D064232:Visual Analog Scale
keywords: Arthroscopy; arthrodesis; brachial plexus palsy; external fixator; glenohumeral fusion; shoulder