Lower trapezius transfer for shoulder external rotation in patients with paralytic shoulder.

Restoration of shoulder external rotation in patients with paralytic shoulder is very challenging. When nerve repair and/or transfer fails, or if patients present late after injury such that nerve reconstruction is not possible, tendon transfer to restore shoulder external rotation becomes the main option. Good outcome has been reported with lower trapezius transfer to the infraspinatus to restore shoulder external rotation in patients with paralytic shoulder. The purpose of this manuscript is to describe the surgical technique of this transfer.