Secondary Surgery

Shoulder Deformity, Shoulder Contracture, Tendon Transfer, Osteotomy


Introduction

Either the brachial plexus lesions have been surgically repaired or a spontaneous recovery is expected, the baby continues to be seen at the Center periodically to evaluate the correct development of recovery. The time necessary for the recovery to develop depends on the type, the level, the extension of the lesions and from the type of surgical repair. For example in a superior paralysis (the so-called Erb's palsy) where the function of shoulder and the flexion of the elbow are mainly affected, an average time of 2 years is necessary to assess a stable final result. But in many instances, only a partial recovery may occur. Especially in spontaneous recovery, we can assist a muscular imbalance due to the predominant function of some muscular groups which are strong, being normal in relationship to the weak or absent paralysed groups. Normally the internal rotators (that allows the hand to reach the back of the body) are not affected by the paralysis, therefore the child is able to internally rotate his arm but not the contrary.