Arthrodesis of the shoulder in children

Ten children had an arthrodesis of the shoulder for a paralytic condition involving the muscles; nine of them were available for long-term follow-up. In the children who were eight to fifteen years old at the time of operation, the angle of arthrodesis was 45 degrees of abduction, 25 degrees of flexion, and 25 degrees of internal rotation. This angle allowed symptomless and useful function of the extremity. No patient had a stress fracture or discomfort when the arm was at rest at follow-up. An asymptomatic click in the acromioclavicular joint in one patient indicated that this may be a future site of abnormality. The children apparently accommodated easily to the arthrodesis of the shoulder. Neither self-image nor overall function seemed to be impaired by the operation. The over-all function postoperatively was related to the neurological integrity of the distal muscles.