Operative methods and surgical results for brachial plexus palsy are influenced by the paralytic status of the patient. From 1971 to 1990, we operated on 29 elbow (27 cases: flexoplasty, 2 cases extensor plasty) and 21 shoulder plasties.The methods for elbow flexoplasties included intercostal nerve transfer (16 cases), Steindler's method (7 cases) and latissimus dorsi transplantation (3 cases). The extensor plasties involved transplantation of latissimus dorsi and biceps brachii. For shoulder reconstruction, we used trapezius and levator scapulae transfer (13 cases), arthrodesis (4 cases), rotation osteotomy of the humerus (3 cases), glenoid plasty (1 case) and pectoralis major transfer with elongation of latissimus dorsi (1 case).The results of intercostal nerve transfer were influenced by the patient's age at operation and duration after the injury, with flexor power of the elbow increasing to three or four one year after surgery. All except two patients, operated on by Steindler's method or Latissimus dorsi transfer achieved good power of elbow flexion.For shoulder reconstruction with root avulsion, we believe that the results achieved with trapezius and latissimus dorsi transfer are better than those of arthrodesis.