ABSTRACT
Paralysis of muscles of the shoulder in children is most frequently seen following obstetric brachial plexus injuries. Non-progressive shoulder paralysis may also be seen following poliomyelitis. The deformities secondary to muscle imbalance that are seen in obstetric palsy vary from patient to patient depending on the pattern of paralysis. Each of the deformities is masked by compensatory positioning of the scapula. Attempting to stretch the contracted muscles causes the scapula to stand out prominently. The extent of paralysis of muscles of the shoulder, elbow and hand and the power of the scapulothoracic muscles are all of vital importance. If the shoulder is flail, the only available option to improve shoulder function is an arthrodesis. Shoulder arthrodesis is a salvage option for dealing with a paralysed shoulder should other options fail. It is desirable to leave all muscles that move the scapula untouched in case an arthrodesis becomes necessary in children with more extensive paralysis.
