Abstract
We have performed Bateman's trapezius transfer for the reconstruction of paralyzed shoulders in Tohoku University Hospital. In the last 14 years, we followed up 12 cases i. e.12 shoulders of 10 males and 2 females. The age at operation time ranged from 6 to 43 years, with an average of 23 years. The causative diseases were 11 traumatic brachial plexus palsies (2 total types,9 upper types including 3 birth palsies) and one axillary nerve palsy. The average follow-up period was 7 years.
Improvement of the active abduction angle after operation was from 0° to 110°, with a mean improvement of 39.2°. But the value in each case varied greatly. On the other hand, passive elevations were preserved at 136.5° on the average. According to the postoperative course, many patients had maximum angles of abduction within a year of operation and then the angle gradually decreased in most of the cases. At follow-up, all the patients could carry light-weight materials or hold them under their axillae. But 4 of the 5 cases, whose dominant arms were involved, began to use their non-dominant arms mainly, except in the axillary nerve palsy case. X-rays showed instabilities in 4 cases.
We evaluated several factors which might affect the results, such as the degree of paralysis, the position of the muscle transfer, the existance of C-C ligament and the postoperative treatment. The important factors were that in patients with preserved power of steering and depressor groups or in those with released C-C ligament, the results were good. However, in patients with anterolateral transfer, the results were poor.
