chapter  22
12 Pages

Sequelae of the shoulder in obstetric palsy

ByAlain Gilbert

After spontaneous recovery or surgical repair of the obstetric brachial plexus, the sequelae at the shoulder level may be disabling, but can be treated surgically. Lack of passive medial rotation should be rapidly treated by subcapularis release in order to avoid secondary joint incongruence. The paralytic shoulder can be improved by latissimus dorsi transfer or trapezius transfer. These operations give constant improvement, but the results are better in young patients. Lack of appropriate rehabilitation and disuse will lead to decreased mobility, a recurrence of the medial rotation contracture, and joint anomalies, with retroversion of the glenoid and posterior subluxation of the humeral head.