Shoulder Arthrodesis: A New Technique

Abstract

Background. The replacement of fusion by arthroplasty in terminal shoulder arthropathies has led to the emergence of cases contraindicated for revision arthroplasty. Performing fusion by traditional methods in such cases is extremely risky because of unfavorable conditions: absence of the humeral head, thinning of the metaphysis walls, and defects of the glenoid. Thus, the creation of a new shoulder fusion technique is necessary. The study aimed to show the possibilities of a new shoulder fusion technique in treating arthroplasty complications and terminal shoulder arthropathies. The surgical procedure includes the resection of the shoulder joint and internal fixation with a special device containing a scapular fork with four locking screws and a bone plate. The fork was put on the scapular spine from the side of its notch and was blocked by four tightening screws, which clamped the scapular spine in the fork. The bone plate fixed the diaphysis of the humerus. The fixator form set the scapulohumeral ratio for the formation of ankylosis in a functional position. Bone grafting was performed with a graft from the wing of the iliac bone according to the special technique after endoprosthesis removal or with the resected head of the humerus in case of arthrosis. Conclusions. The developed technique can be used as a standard revision option for contraindications to shoulder arthroplasty and for any traditional indications for its fusion, such as oncological resections, consequences of open and gunshot trauma, lesions of the brachial plexus, and terminal arthropathies in persons engaged in heavy physical labor when it is impossible to change profession.

Keywords

• shoulder arthrodesis
• shoulder ankylosis
• shoulder arthropathy
• complications of shoulder arthroplasty
• bone grafting