Shoulder Arthrodesis With Reamer Irrigation Aspiration Bone Grafting in Patients With Brachial Plexus Injury

Brachial plexus injuries (BPI) can result in irreversible functional loss of shoulder girdle musculature leading to humeral head subluxation and instability. The resultant mechanical pain can be debilitating and unresponsive to neuropathic pain medications. Surgical intervention, in the form of shoulder arthrodesis (SA), stabilizes the joint and can help to relieve this mechanical pain. Outcomes after SA have been variable in the general population, with high reported rates of nonunion. This is of particular concern in patients with BPI as they often have disuse osteopenia. Here, we describe the use of the Reamer-Irrigator-Aspirator system (RIA, DePuy Synthes, Raynham, MA) for harvesting of autologous bone graft that is used in conjunction with plate and screw fixation for SA in patients with BPI. This study details the operative technique as well as the early outcomes in the first 4 patients.