Tuberculous disease of the shoulder joint recovers slowly by fibrous ankylosis which becomes sufficiently firm to maintain the abducted position only after several years' fixation. The disease occurs most commonly in the adult, and the average duration of conservative treatment is three to five years. Attempted acceleration of treatment reduces the scapulohumeral angle and abduction movement is lost.
For these reasons operative fusion of the joint is indicated as a terminal stage of treatment after quiescence has been secured by conservative measures. Roentgenographic evidence of quiescence, shown by recalcification of the bones, appears within about twelve months.
A new operation is described by which solid bony fusion can be secured without opening the joint, and the arthrodesis is definitely extraarticular. The cosmetic result is considerably improved by the operation.
Three cases are reported in which a sufficient interval of time has elapsed to judge the operation. In no case was there any aggravation of the disease or recurrence elsewhere, and in all three cases bony ankylosis resulted.