Vol. 7, Issue 4 (2021)

Purpose: The aim of this study was to evaluate the long-term outcome of shoulder arthrodesis with plate fixation and primary autogenous grafting in terms of pain, functional status, and arthrodesis position.

Method and Material: The study included 8 patients (7 males and 1 female; mean age: 46.5 years; range: 42 to 55 years) who underwent arthrodesis with plate fixation and primary autogenous grafting. Mean follow-up period was 18 months. Four cases had blast injury, TB shoulder in 2 patients, sequalae of septic arthritis and paralytic disorder in 1 each. Arthrodesis was performed in all cases according to AO principles with plate fixation and primary autogenous grafting. Follow-up assessments included monthly radiologic control for union, the visual analog scale (VAS) for pain and the Oxford shoulder score (OSS) for functional status.

Results: Radiological fusion was seen in all cases in an average of 16 (range: 12 to 18) weeks, and arthrodesis was stable at physical examination. The accompanying humerus shaft fracture was also fixed with plate. One patient with traumatic palsy experienced a humerus fracture distal to the arthrodesis plate at the 8th postoperative month. Two patients had a superficial wound infection after surgery. One patient had hardware symptoms and latissmus dorsi flap was done. The target positions of 30° of abduction, 30° of forward flexion, and 30° of internal rotation were achieved with an average deviation of 7°. Mean active abduction was 68.1° (range: 55° to 90°), flexion was 67.5° (range: 60° to 85°), and internal rotation was at the level of trochanter. The mean OSS was 35.9 (range: 32 to 40), and the mean VAS score was 2.9 (range: 1 to 7).

Conclusion: Our findings show that AO reconstruction plate and primary autogenous bone grafting is a safe and effective arthrodesis method that can also be used as a salvage procedure.