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J Hand Surg Am. 2015 Jan;40(1):148-51. doi: 10.1016/j.jhsa.2014.10.018. Epub 2014 Nov 20.

Anterior glenohumeral joint stabilization in tetraplegic patients by medializing the anterior head of deltoid muscle.

Author information

1
Department of Orthopedic Surgery, Hospital of Saint-Pierre, University of La Réunion Island, Saint-Pierre, La Réunion Island; Laboratoire DIMPS, Le Tampon, Ile de La Réunion; Centre Mutualiste Neurologique Propara and the Hand and Upper Limb Institute, Montpellier, France. Electronic address: richardballas@yahoo.fr.
2
Department of Orthopedic Surgery, Hospital of Saint-Pierre, University of La Réunion Island, Saint-Pierre, La Réunion Island; Laboratoire DIMPS, Le Tampon, Ile de La Réunion; Centre Mutualiste Neurologique Propara and the Hand and Upper Limb Institute, Montpellier, France.

Abstract

To improve control of the upper limb in high-level tetraplegic patients, the proximal shoulder must be the first consideration. Medialization of the anterior part of the deltoid muscle provides stabilization and is then an antagonist to the posterior deltoid when a pectoralis major palsy exists. It can also be performed in isolation in high-level tetraplegia even when there is little hope of distal extremity reconstruction to stabilize the shoulder. It also precedes the ability to restore elbow extension and perform further reconstructive hand surgery. We describe the surgical technique and report a clinical case.

KEYWORDS:

Tetraplegia; deltoid; elbow paralysis; shoulder paralysis; tendon transfer

PMID:
25455098
DOI:
10.1016/j.jhsa.2014.10.018
[Indexed for MEDLINE]

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