The Journal of Bone and Joint Surgery, Vol 59, Issue 3 317-321, Copyright © 1977 by Journal of Bone and Joint Surgery, Inc
Early arthrodesis for a flail shoulder in young children
M Makin
In seven children, five to nine years old, with a flail shoulder and a
functional hand and elbow, arthrodesis of the shoulder in 80 to 90 degrees
of abduction was performed by denuding the humeral head and glenoid of
cartilage and fixing the humerus to the glenoid with Steinmann pins first
inserted in the humerus in a proximal-distal direction and then driven in
the reverse direction into the glenoid. Postoperatively each limb was
immobilized in a spica cast, the pins were removed after a month, and the
cast was removed after ten to twelve weeks when union was evident. All
seven fusions united and function was much improved. When these children
were followed to adult life there was only a small loss in humeral length
and no change in position of the fused shoulder. Early arthrodesis is
advocated in the treatment of a flail shoulder in children.
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