Tendon-muscle plastic surgery in the treatment of contractures of the shoulder joint in children with natal and postnatal injuries of the brachial plexus

During the period 1980 through 2003,55 patients aged 3—17 years, with adductive internal rotation shoulder contractures resulted from natal and neonatal brachiplex injury were operated on. Sixty six surgical procedures including Chizhik-Poleiko, Episcopo, Meyer operations, derotation humerus osteotomy, shoulder lavsanodesis were performed. Good results were achieved in 39 patients (70.9%), satisfactory results — in 15patients (27.3%o) and unsatisfactory result — in 1 patient (1.8%). It is shown that the most effective procedures are various types of tendon- muscular plasty directed to the restoration of shoulder function. The best results have been achieved in children under 10 years. Indications and contraindications to derotation humerus osteotomy are detected.