Shoulder arthrodesis with reconstruction plate aims to relieve pain and provide a stable site for elbow and hand function and also to allow for active and limited elevation of the shoulder with scapulothoracic motion. Plates are a useful method for glenohumeral salvage in cases without severe bone deficiency with the advantage that the plate can be bent easily and precisely depending on the anatomical position and adequate bony arthrodesis can be achieved. Sometimes autologous and homologous bone grafting is performed in tuberculous arthritis, bone tumors to correct severe bone deficit.
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Indications
Evaluation criteria include bony union and pain
Indications for shoulder arthrodesis are:
restoration of shoulder joint stability
brachial plexus paralysis
correction of failed shoulder arthroplasty
treatment of joint infection with severe joint destruction
Procedure
Combination of intra-articular and extra-articular fixation with adequate stability and bony fusion after intra-articular fixation with reconstruction plate, better with polyether-ether-ketone (PEEK).
Complications
Complications of shoulder hemiarthroplasty include the following:
bony nonunion
malposition of the joint
fracture around the arthrodesis
infection
pain and irritation of soft tissues by of the implant
Radiographic features
Success of arthrodesis is determined by bone growth across the glenohumeral joint as visualized on axillary radiographs.
Plain radiograph
Anteroposterior and axillary views are usually obtained initially for postoperative control and also for follow-up examinations. Follow-up radiographic imaging is performed at 2, 6, 12, and 24 months after surgery to evaluate bone union, position of fixation devices, possibly with polyether-ether-ketone (PEEK), to prevent stress shielding of the proximal humerus with bone resorption.
Radiological report
The radiological report should include a description of the following features:
radiologic bone fusion with bone growth of the glenohumeral joint that occurs on average within 4 to 14 months after surgery. When there is radiological bony union, shoulder pain is completely abolished
study glenohumeral implant: plate and screws
possible fractures
The implants are removed after an average of approximately 16 months.
History and etymology
'Arthrodesis' is derived from the Greek words άρθρωση + δέσῐς, meaning 'joint' and 'binding together', respectively.
Scapulohumeral arthrodesis was first introduced in 1878 by the Bohemian surgeon Eduard Albert.