Deltoid muscular flap transfer for the treatment of irreparable rotator cuff tears

  • Justus Gille | justus_gille@usa.net Department of Trauma and Reconstructive Surgery, University of Schleswig-Holstein, Germany.
  • Joerg Suehwold Regio Clinics Wedel, Department of Trauma Surgery, Holmerstr. 155, 25421 Wedel, Germany.
  • Arndt-Peter Schulz Department of Trauma and Reconstructive Surgery, University of Schleswig-Holstein, Germany.
  • Benjamin Kienast BG Trauma Hospital Hamburg, Germany.
  • Andreas Unger Department of Trauma and Reconstructive Surgery, University of Schleswig-Holstein, Germany.
  • Christian Jürgens BG Trauma Hospital Hamburg, Germany.

Abstract

The purpose of this study was to evaluate the outcome of deltoid muscle flap transfer for the treatment of irreparable rotator cuff tears. In a retrospective study 20 consecutive patients were evaluated. The index procedure took place between 2000 and 2003. Fifteen patients were male, mean age was 62 years. Inclusion criterion was a rotator cuff defect Bateman grade IV. Exclusion criteria were smaller defects, shoulder instability and fractures of the injured shoulder. An open reconstruction with acromioplasty and a pedicled delta flap was performed. Follow up period was mean 42 months. Follow-up included clinical examination, Magnetic Resonance Imaging (MRI) and the Constant and Simple (CS) shoulder tests. According to the Constant shoulder test the results were good in 13 patients, fair in 5 and unsatisfactory in 2. The pre-operative Constant Score improved from mean 25.7 points (±5.3) to 72.3 (±7.8) at follow-up. The mean values for the subcategories of CS increased significantly from 3.9 to 14.4 points for pain and from 4.2 to 15.9 points for activities daily routine (p<0.05). The change in range of motion and strength were not significant (p>0.05). Results of the Simple Shoulder Test showed a significant increase of the mean values from pre-operative 4.3 to 14.7 points post-operatively. MRI showed a subacromial covering of the defect in all cases, all flaps where intact on MRI but always the flap showed marked fatty degeneration. In conclusion, the delta flap is a simple method for the repair of large defects of the rotator cuff leading to satisfying medium results.

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Author Biographies

Justus Gille, Department of Trauma and Reconstructive Surgery, University of Schleswig-Holstein

 

Consultant

Department of Trauma and Reconstructive Surgery, University of Schleswig-Holstein, Campus Lübeck

Joerg Suehwold, Regio Clinics Wedel, Department of Trauma Surgery, Holmerstr. 155, 25421 Wedel

Consultant

Regio Clinics Wedel,

Department of Trauma Surgery,

Holmerstr. 155,

25421 Wedel

Arndt-Peter Schulz, Department of Trauma and Reconstructive Surgery, University of Schleswig-Holstein

Consultant

Department of Trauma and Reconstructive Surgery, University of Schleswig-Holstein, Campus Lübeck

Benjamin Kienast, BG Trauma Hospital Hamburg

Consultant

BG Trauma Hospital Hamburg

Bergedorfer Str. 10

21033 Hamburg

Andreas Unger, Department of Trauma and Reconstructive Surgery, University of Schleswig-Holstein

Consultant

Department of Trauma and Reconstructive Surgery, University of Schleswig-Holstein, Campus Lübeck

Christian Jürgens, BG Trauma Hospital Hamburg

Head of the Department

BG Trauma Hospital Hamburg

Bergedorfer Str. 10

21033 Hamburg

Published
2009-09-01
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Section
Original Articles
Keywords:
Shoulder, rotator cuff, massive rotator cuff tear, deltoid muscle flap
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How to Cite
Gille, J., Suehwold, J., Schulz, A.-P., Kienast, B., Unger, A., & Jürgens, C. (2009). Deltoid muscular flap transfer for the treatment of irreparable rotator cuff tears. Orthopedic Reviews, 1(2), e15. https://doi.org/10.4081/or.2009.e15