The secondary reconstruction procedures to improve the function and stability include shoulder arthrodesis, rotational osteotomy of the humerus and tendon-muscular transfers or a combination of these techniques.
When shoulder arthrodesis fails, no other option remains for reconstruction of the shoulder function.
7,8] Saha  and Goldner  came to the conclusion that shoulder arthrodesis should be regarded as the last resort and muscle transfers as the best option.
Shoulder arthrodesis for the treatment of brachial plexus palsy.
Thirteen months after the initial injury, with no clinical or electromyographic evidence of recovery, the patient underwent transhumeral amputation and shoulder arthrodesis (Figure 9).
He is most satisfied with the stable shoulder arthrodesis and amputation, because he no longer dislocates his shoulder and the flail arm no longer gets in his way.