11:28
Published February 01, 2014

Shoulder Arthrodesis: Surgical Technique

Shoulder arthrodesis is an uncommon salvage procedure that is most commonly performed in patients with intractable instability or paralytic disorders of the upper extremity. Several techniques for shoulder arthrodesis have been described over the past century. Recently, shoulder arthrodesis has been performed using malleable reconstruction plates, and has been shown to be a reliable and stable construct to promote bony fusion. This surgical video demonstrates a technique for shoulder arthrodesis that uses modern fixation methods and implants. In the video, a 22-year-old woman with intractable end-stage instability who failed multiple prior surgeries undergoes shoulder arthrodesis to alleviate pain and provide stability. An anterolateral approach to the proximal humerus and glenohumeral joint is demonstrated. The video shows the anatomic dissection, isolation of the axillary nerve, and preparation of the fusion surfaces. A malleable reconstruction plate that extends over the scapular spine and bends inferiorly down the shaft of the humerus is contoured, and a glenoacromiohumeral fusion is achieved. The video shows positioning, surgical technique, hardware placement, and fluoroscopic evaluation. Patient follow-up is also demonstrated. Although considered a salvage procedure, results from the literature and from our experience have been favorable, demonstrating that shoulder arthrodesis can be a successful operation for carefully selected patients.