Abstract
Background: The lack of external rotation and shoulder abduction as sequelae of obstetric brachial plexus palsy requires a release of the subscapularis muscle associated with tendon transfer of the internal rotator of the shoulder. The aim of this study was to present the results of a teres major transfer to the infraspinatus tendon.
Methods: This study included 20 patients (9 boys and 11 girls) with a mean age of 3 years 8 months (range, 1.5-14 years). The average follow-up time was 42 months (range, 12-48 months) to determine whether external rotation weakness and internal rotation contracture sequelae were managed by anterior release of the subscapularis and teres major tendon transfer to the infraspinatus tendon.
Results: We found marked improvement in shoulder abduction from 67 degrees before surgery to 158 degrees after surgery. We also found marked improvements in active external rotation from 8 degrees before surgery to 85 degrees after surgery and in passive external rotation from 0 degrees preoperatively to 72 degrees postoperatively. Two cases showed a loss of the last degrees of internal rotation, but this improved after physiotherapy.
Conclusions: Anterior release of the subscapularis tendon with a teres major transfer to the infraspinatus tendon significantly improves shoulder function in Erb palsy patients with internal rotation contracture. (C) 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.