The humeral suspension technique: a novel operation for deltoid paralysis

Abstract

Isolated deltoid paralysis is a rare pathology that can occur after axillary nerve injury due to shoulder trauma or infection. This condition leads to loss of deltoid function that can cause glenohumeral instability and inferior subluxation, resulting in rotator cuff muscle fatigue and pain. To establish dynamic glenohumeral stability, a novel technique was invented. Humeral suspension is achieved using a double button implant with non-resorbable high strength cords between the acromion and humeral head. This novel technique was used in two patients with isolated deltoid paralysis due to axillary nerve injury. The results indicate that the humeral suspension technique is a method that supports centralizing the humeral head and simultaneously dynamically stabilizes the glenohumeral joint. This approach yielded high patient satisfaction and reduced pain. Glenohumeral alignment was improved and remained intact 5 years postoperative. The humeral suspension technique is a promising surgical method for subluxated glenohumeral joint instability due to isolated deltoid paralysis.

Keywords: Axillary nerve injury; Brachial plexus neuropathies; Glenohumeral instability; Humeral suspension technique; Deltoid muscle paralysis.

Fig. 1.

Preoperative anteroposterior X-ray of the right shoulder of patient 1 with inferior subluxation.

Fig. 2.

Anteroposterior and lateral views of the right shoulder with Fibertape channeled through the acromion and proximal humerus.

Fig. 3.

Anteroposterior X-ray of the right shoulder of patient 1 at postoperative 5 years.