When the axillary nerve does not recover following injury, and when acute treatment is not provided---by 3-6 months following injury-----the deltoid muscle usually undergoes irreversible atrophy. In order to restore functional "scaption"-----forward elevation of the arm in the plane of the scapula--shoulder fusion can be performed; this is a time-honored option. The only other option involves tendon transfer--both the latissimus dorsi and trapezius muscles have been used as donors.
In my experience, shoulder fusion provides the most reliable restoration of function, but requires 6 weeks in an orthosis, to immobilize the shoulder until union occurs.
In my experience, shoulder fusion provides the most reliable restoration of function, but requires 6 weeks in an orthosis, to immobilize the shoulder until union occurs.
