Pedicled Pectoralis Major Transfer for Axillary Nerve Palsy and Greater Tuberosity Nonunion: A Case Report
Sameer R Khawaja1, Musab Gulzar, Thomas J McQuillan
1Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia.
Case:
A 46-year-old male patient presented with shoulder pain, limited range of motion, and loss of sensation for a year after undergoing hemiarthroplasty for a proximal humerus fracture. Workup demonstrated a greater tuberosity nonunion and deltoid paralysis secondary to upper trunk brachial plexopathy. The pectoralis major (PM) for deltoid transfer successfully restored shoulder function and resolved pain without requiring any subsequent intervention.
Conclusion:
A PM transfer for deltoid and rotator cuff insufficiency restored shoulder stability and improves biomechanics for shoulder abduction and flexion in this case. Dynamic radiography demonstrates enhanced fluidity of shoulder kinematics with improved scapulohumeral motion.
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