A one-stage shoulder arthrodesis and Brooks Seddon pectoralis major to biceps tendon transfer for upper brachial plexus injuries

Reconstructive procedures to optimise the function of patients with upper brachial plexus injuries are well described. From 1999 to 2005, nine patients underwent a single stage Brooks Seddon pectoralis major to biceps tendon transfer with a glenohumeral arthrodesis for restoration of elbow flexion and shoulder stability. All of these patients had sustained traumatic upper trunk brachial plexus injuries which had not responded to nerve repair, grafting or neurotisation or had a delayed presentation. Results were assessed using a goniometer and the Medical Research Council strength grading. At follow-up of 28.5 months, the average arc of elbow flexion was 103 degrees and eight had good elbow flexion power. There was one failure. We had two complications, both related to humerus fractures below the arthrodesis plate. Both united with conservative treatment. Our experience has given encouraging results with a high level of patient satisfaction. Our indications, operative technique and results are presented.