Abstract
Background After severe brachial palsy involving the shoulder, many different muscle transfers
have been advocated to restore movement and stability of the shoulder. Paralysis of
the deltoid and supraspinatus muscles can be treated by transfer of the trapezius.
Methods We treated 10 patients, 8 males and 2 females, by transfer of the trapezius to the
proximal humerus. In 6 patients the C5 and C6 roots had been injuried; in one C5,
C6 and C7 roots; and 3 there were complete brachial plexus injuries. Eight of the
10 had had neurosurgical repairs before muscle transfer. Their average age was 28.3
years (range 17 to 41), the mean delay between injury and transfer was 3.1 years (range
14 months to 6.3 years) and the average follow-up was 17.5 months (range 6 to 52),
reporting the clinical and radiological results. Evaluation included physical and
radiographic examinations. A modification of Mayer’s transfer of the trapezius muscle
was performed. The principal goal of this work was to evaluate the results of the
trapezius transfer for flail shoulder after brachial plexus injury.
Results All 10 patients had improved function with a decrease in instability of the shoulder.
The average gain in shoulder abduction was 46.2°; the gain in shoulder flexion average
37.4°. All patients had stable shoulder (no subluxation of the humeral head on radiographs).
Conclusion Trapezius transfer for a flail shoulder after brachial plexus palsy can provide satisfactory
function and stability.
