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Sir, Trapezius muscle transfer is an established method to provide stability and function to the flail shoulder joint in brachial plexus injuries (BPIs) after denervation atrophy of the involved muscles.[1] Two major variants of the surgical technique have been described.[2,3] Saha’s[3] technique includes mobilising the trapezius muscle insertion along with lateral clavicle, acromion process and spine of the scapula, followed by their fixation to the humerus with the help of bone screws. Problems associated with this technique include longer surgery time, prolonged immobilisation, screw loosening, surgical‐site infection and deformities after bony fracture. Singh and Karki[2] mobilised the trapezius insertion subperiosteally without bony osteotomies. The periosteal sleeve was used to secure the transfer to the deltoid muscle using non‐absorbable sutures. There was no bony fixation with a strong reliance on postoperative splintage.

A hybrid technique of trapezius muscle transfer for a flail shoulder in late brachial plexus injuries