1. Arthrodeses of the Shoulder

This survey would indicate that an arthrodesis of the shoulder joint is the operation of choice in all cases of infantile paralysis with complete paralysis of the deltoid. An upper trapezius with only fair power was found to he the only muscle which must be present. If both trapezius and serratus anterior are present, a satisfactory range of motion and power should be obtained. The operation should result in improved function of the upper extremity with little loss of cosmetic effect.

The optimum position of fusion was found in most cases to he 45 to 55 degrees of abduction, 15 to 25 degrees of flexion, and 15 to 25 degrees of internal rotation. A correct degree of rotation was found to be more important from a functional standpoint than the degree of abduction (Figs. 1, 2, 3, and 4).

Postoperative fixation in plaster from a minimum of three months to a maximum of five months appeared sufficient. A fusion operation can be done any time after the age of six years. While in the younger patients, a better range of motion developed, the percentage of failure of fusion was found to be consistently higher.

2. Muscle Transplantions at the Shoulder

The satisfactory muscle transplantations were found only in those cases possessing fair power in the deltoid preoperatively.