Seventy-one shoulders of seventy patients were fused for treatment of
various conditions, and the results were analyzed after an average follow
up of nine years and six months. The operative technique always included
the use of internal fixation. The average position of arthrodesis was 45
degrees of abduction and 25 degrees of flexion of the arm, with the flexed
forearm rotated 21 degrees above the horizontal plane, measured with the
arm abducted and flexed. In sixty-eight shoulders, one operation achieved a
solid fusion; in the other three, a second arthrodesis was required.
Complications included tenderness over the outer ends of the internal
fixation device, which required its removal from seventeen shoulders; a
fracture in the fused extremity in ten patients; and a post-operative
infection in one. Relief of pain was adequate in three-quarters of the
patients. Three-quarters of the patients could perform activities involving
reaching the trunk, one-half could do activities requiring reaching the
head, and one-quarter were able to do light work with the arm at shoulder
level or higher. The position of fusion had little effect on the result.
Eighty-two per cent of the entire group believed that they had benefited
from the operation, and none of the results deteriorated with time.