Shoulder Arthrodesis

Scapular joint fusion is used for the treatment of shoulder deformity. There are two main parts of the shoulder movement: one is the movement of the ankle joint, and the range of motion accounts for 2/3 of the total movement. The second is the movement of the shoulder and the chest, that is, the activity between the shoulder blade and the chest wall. The range of motion is 1/3. When the muscles that control the ankle joint are paralyzed, and the muscles that control the scapula, such as the trapezius muscle and the anterior serratus, are still normal, The shoulder joint fusion is used to drive the upper limb abduction by the rotational movement of the shoulder blade on the thorax. Treatment of diseases: inflammation around the shoulder joint Indication Scapular joint fusion is suitable for: 1. Loss of shoulder joint abduction. 2. The activity of the sterno-lock joint and the acromioclavicular joint is normal. Because the sterno-lock joint has a 60° movement, the acromioclavicular joint has a mobility of 30°, so the maximum compensatory activity between the shoulder and the chest can reach 90°, and there will be different degrees of increase after exercise. Surgical procedure Incision Centered on the shoulders, an inverted U-shaped incision is made from front to back. 2. Exposing the joint Along the acromion, the deltoid muscle was removed, and the deltoid muscle was opened from the medial side. The acromion sac and some joint capsules were removed, revealing the cartilage surface of the humeral head, the joints and the shoulders. 3. Remove cartilage surface The cartilage surface of the humeral head and joints, the joint capsule under the shoulder and the connective tissue are removed. 4. Do bone groove A wedge-shaped bone groove of about 3 cm deep and a base width of about 1 cm was cut inside the large tibial tuberosity. 5. Cut off the shoulder The periosteum at the lateral end of the acromion was peeled off, and the shoulder was partially cut at a distance of 2.5 cm from the acromion, resulting in a partial fracture. 6. Abduction fixation With the shoulder plane as the mark, the shoulder joint is maintained. Generally, for paralyzed patients, the external extension is 60°, the flexion is 20°, and the external rotation is 15°. After positioning, the two needles are used to pass the humeral head and the shoulder blade. Cross-fixing. 7. Bone graft The shoulder is folded down, embedded in the wedge-shaped bone groove of the large nodule, and the cancellous bone dug from the bone groove is implanted into the shoulder blade, between the humeral head and the shoulder peak. When the bone is not enough, the humeral head can be cut. Adjacent to some bone supplements. 8. Stitching First check the fixation and position maintenance. If the steel needle is fixed reliably, the abduction can reach 90°, and the elbow can be attached to the chest to suture the wound.