Source: Journal of Hand Surgery
To improve control of the upper limb in high-level tetraplegic patients, the proximal shoulder must be the first consideration. Medialization of the anterior part of the deltoid muscle provides stabilization and is then an antagonist to the posterior deltoid when a pectoralis major palsy exists. It can also be performed in isolation in high-level tetraplegia even when there is little hope of distal extremity reconstruction to stabilize the shoulder. It also precedes the ability to restore elbow extension and perform further reconstructive hand surgery. We describe the surgical technique and report a clinical case.