الفهرس 
Anatomy of the Brachial Plexus and Axillary RegionOnly 14 pages are availabe for public view
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Abstract
This study included 17 patients with Obstetrical Brachial Plexus Palsy (OBPP) with defective shoulder abduction and external rotation managed with external rotation conjoined tendon transfer via axillary approach. 7 cases (41.2%) were males and 10 cases (58.8%) were females. The right side was affected in 12 cases (70.6%) while the left side was affected in 5 cases (29.4%). Average age at surgery was 5 years, 7 months (ranged from 27 months to 108 years).In our study the mean improvement in shoulder abduction was 90 degrees (77.4% gain) and that in external rotation was 50 degrees (127.36% gain). The improvement in both abduction and external rotation was statistically significant.Internal rotation contracture is the most frequent and important secondary deformity of the shoulder in birthpalsy. Once passive external rotation is improved, the child is assessed for muscle transfers to reconstruct active externalrotation if necessary.Transfer of the conjoined tendon of TM and LD to the infraspinatus, allowing the deltoid to act with maximal force, and it is a useful procedure for correction of defective shoulder abduction and external rotation in OBPP. The basic advantage of this procedure over other tendon transfersis the increased stabilizing action of the rotator cuff.