Between 8/95 and 12/01 15 patients underwent tendon transfer of the latissimus dorsi and teres major muscle for late reconstruction in the treatment of Erb’s palsy. 6 of the 15 patients underwent an additional subscapularis and anterior shoulder capsular release. The mean patient age was 7 years (range 32 months to 15 years), mean birth weight 4110 gm(range 3720 gm to 4530 gm). 7 of the patients were female and 8 male. The brachial plexus injuries affected the right side in 9 cases and the left side in 6 cases. The roots C5-6 were involved in all cases with a preoperative muscle strength 0 to 1/5 for external rotators of the shoulder and deltoid muscle, the roots of C7 were partially affected in 13/15 cases. The postoperative care consisted of a defined serial casting protocol for 6 weeks. For the following 6 months the patients underwent a defined therapy protocol for balance, ROM and strengthening by our Hand and Occupational Therapy Center. The results were documented in pre and postoperative ROM measurements in the 3 and 6 months postoperative follow up. The measurements were taken for anterior flexion, horizontal abduction and external rotation of the affected shoulder. The mean improvement for anterior flexion was 37 degrees (range 0 to 90), for horizontal abduction 30 degrees (range 0 to 90) and for external shoulder rotation 34 degrees (range 10 to 70) at 6 months postoperatively. There were no major complications. One patient required an additional derotational osteotomy of the humerus due to persistent internal rotation contracture. The ROM improvement was significant (p<.01).