Introduction:
Combined injuries to the suprascapular and axillary nerves can result in irreversible dysfunction of the shoulder joint, with reconstruction of shoulder external rotation being an essential component of an effective treatment. Transfer of the lower portion of the trapezius to the infraspinatus has been used, with success, to regain external rotation of the shoulder.
Case report:
We present the case of a 45-year-old man with a chronic traumatic injury of the suprascapular and axillary nerves. In addition to a surgical transfer of the lower trapezius to the infraspinatus, we included a transfer of the latissimus dorsi and teres major, with a tensor fasciaelatae graft to the supraspinatus tendon insertion, to improve the muscular strength of shoulder elevation and abduction, as well as to improve external rotation. At 24-month post-surgery, the patient had recovered 170° of shoulder elevation, 170° of abduction, and 60° of external rotation.
Conclusion:
Early recovery after surgery was achieved, with excellent improvement of the range of shoulder motion. We report the transfer of the lower trapezius to the infraspinatus might provide a useful salvage procedure for patients with poor functional prognosis of a chronic suprascapular nerve injury.