Muscle transpositions in the shoulder and upper arm for sequelae of brachial plexus palsy

Permanent deficiency in abduction and external rotation of the arm seen after brachial plexus injury may be corrected by a levator scapulae transposition onto the supraspinatus, while the teres major, associated or not with latissimus dorsi, is transferred onto the infraspinatus muscle. Transposed in a bipolar manner, the latissimus may compensate the deltoid muscle. Associated measures have to be carried out in children with deformities caused by obstetrical palsy. A paralysed serratus anterior is best compensated by a transfer of the pectoralis major together with pectoralis minor muscle.