Shoulder external rotator selective neurotomy in cerebral palsy: anatomical study and preliminary clinical results

Shoulder external rotation posturing in patients with cerebral palsy can severely impair bimanual activities and lead to painful shoulder instability. We performed an anatomical study to describe the surgical approach to the shoulder external rotators nerves. Using this technique, we performed a selective neurotomy in five shoulders with external rotator shoulder spasticity. Ashworth scale dropped from 2 or 3 to 0 and active internal rotation increased from 0-10 to 60-70 degrees . This is a short series but preliminary results are encouraging and allow us to extend the study to a greater number of patients.