A series of fourteen patients treated by arthrodesis of the shoulder is presented. In eleven patients arthrodesis was indicated for paralysis secondary to poliomyelitis. In two patients fusion was performed to relieve pain caused by destruction of the joint; in one instance by a benign cyst of the head of the humerus and in the other by an unreduced fracture-dislocation of the glenohumeral joint. In the remaining patient the arm was useless because of an old injury to the brachial plexus. In the presence of adequate power in the trapezius and serratus anterior, function was improved by supracondylar amputation, shoulder fusion, and the use of a prosthesis.
The most satisfactory position for fusion of the glenohumeral joint is elevation to 60 degrees, abduction to 65 degrees, and outward rotation to 40 degrees. Fixation by a screw of the wood-screw type and the addition of autogenous iliac grafts in this series produced sound fusion in the desired position after three months of immobilization. Satisfactory results depend on correct position and adequate muscle power (good or better) in the trapezius and anterior serratus.