Midterm Observational Study Results After Glenohumeral Arthrodesis With a Locking Compression Plate in Paralytic Shoulder.

Purpose

To evaluate bone union, hardware removal, complications, and functional outcomes after glenohumeral arthrodesis using a locking compression plate positioned beneath the acromion in patients with paralytic shoulder.

Methods

A retrospective observational study was performed at a tertiary referral center. Patients who underwent glenohumeral arthrodesis with a locking compression plate between 2011 and 2025 were included. Demographic data, etiology of paralysis, prior treatments, complications, and need for secondary surgery were recorded. Radiographic union was assessed during follow-up. Postoperative active shoulder abduction and active flexion were measured, and hand-to-mouth ability was documented. Patient-reported outcomes were evaluated using the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire. The association between scapulohumeral fusion angle and postoperative shoulder motion was analyzed.

Results

Seventeen patients met the inclusion criteria, with a mean follow-up of 4.8 years. No patient required plate removal due to hardware intolerance. Glenohumeral fusion was achieved in all cases. One patient required early reoperation due to symptomatic screw prominence, and two patients sustained peri-implant humeral fractures, one of which required surgical fixation. Mean postoperative shoulder active range of motion was 56° in abduction and 58° in flexion. Twelve patients achieved hand-to-mouth. The mean Quick Disabilities of the Arm, Shoulder, and Hand score was 28. A significant positive correlation was found between the scapulohumeral fusion angle and postoperative active shoulder abduction and flexion.

Conclusions

In this cohort, glenohumeral arthrodesis using a subacromial locking compression plate provided reliable bone union and a low complication rate. No patient required plate removal due to intolerance at the midterm follow-up. Scapulohumeral fusion angle was positively associated with postoperative active shoulder motion. This technique represents a useful option in selected patients with shoulder paralysis. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic IV.