The 2003 Annual Meeting of OASYS_NEW

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Static Aand Dynamic Forces to Control the Shoulder Joint

Millesi H, Vienna Private Hospital, Ludwig Boltzmann Inst.f.Exp.Plastic Surgery, A 1090 Peelikanggaasse 15, Vienna, Austria, Reihsner R, Technical University Vienna, Ludwig Boltzmann Inst.Exp.Plastic Suurgery, Vienna, Austria, and Millesi D, ASPN, USA.

At the shoulder Joint the humerus is kept in place by a resting force of the following muscles: Deltoid Supraspinatus Long head of the Biceps Long head of the Triceps If especially the Deltoid and the Supraspinatus are paralysed the head of the humerus luxates partially until the soft connective tissue becomes elongated enough to prevent further luxation. Different techniques have been designed to transfer non paralysed muscles e.g. part of the Trapezius or the Levator scapulae to improve active motion in a paralytic shoulder joint after a Brachial Plexus Lesion. Even after successful surgery of this kind one can observe the a great percentage of the power of transfered muscles is consumed for static correction Lifting the head of the humerus in the correct position and only a fraction is left for the desired active motion. We have analysed this problem from the m echanical point of view and came to the conclusion that a better result can be achieves if the static and dynamic forces are divided . The static force to maintain the head of the Humerus in place is provided by a Fascia lata sling across the Acromion and the head of the Humerus.The trandfered muscle is then protected against elongation and its force is fully available for motion. This principle is demonstrated by a series of cases according to this line.