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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
A functional analysis of shoulder fusions
1Department of Orthopaedic Surgery, University of Western Ontario, St. Joseph's Hospital, London, Canada.
Clinical Orthopaedics and Related Research
|October 1, 1987
Summary
Shoulder fusion significantly limits daily activities, especially overhead tasks. Optimal positioning is crucial, but functional deficits persist even in the ideal surgical outcome.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
Background:
- Shoulder fusion (arthrodesis) is a surgical option for painful, nonfunctional shoulders.
- Understanding functional limitations post-fusion is critical for patient counseling.
Purpose of the Study:
- To analyze the functional outcomes of shoulder fusions in patients with normal musculature.
- To identify the impact of fusion positioning on activities of daily living (ADL).
Main Methods:
- Retrospective analysis of seventeen shoulder fusions.
- Exclusion of joints fused for paralysis.
- Assessment of functional ability for ADL.
Main Results:
- Patients experienced significant limitations in overhead work and abducted arm activities.
- Hygiene and behind-the-back functions were frequently difficult.
- Rotational positioning critically impacted head-level and posterior function.
- Recommended position: 25-40° abduction, 20-30° flexion, 25-30° internal rotation.
Conclusions:
- Shoulder fusion imposes substantial functional deficits, even in the recommended position.
- Informed consent must include a thorough discussion of these limitations and surgical risks.
- Patient expectations should be managed regarding the degree of functional recovery.
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