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. 2004 Aug;28(4):226-30.
doi: 10.1007/s00264-004-0565-y. Epub 2004 May 27.

Massive tears of the rotator cuff treated with a deltoid flap

Eric Vandenbussche  1 , Moncef Bensaïda, Céline Mutschler, Thierry Dart, Bernard Augereau
Affiliations

Massive tears of the rotator cuff treated with a deltoid flap

Eric Vandenbussche et al. Int Orthop. 2004 Aug.

Abstract
in English, French

We retrospectively reviewed the charts of 29 patients younger than 65 years at surgery treated with deltoid flap reconstruction for massive postero-superior rotator cuff tears. All tears involved supraspinatus and infraspinatus tendons and were associated with tendon stump retraction to the glenoid rim, a preservable long biceps tendon, and an intact subscapularis tendon. Mean follow-up was 10.5 years. Patient satisfaction rate was 89%. Mean global Constant score improved from 43 to 71.5 points, mean pain score from 6.3 to 13.2, mean anterior flexion from 100 to 157 degrees, and force in elevation from 2.3 to 3 kg. Two thirds of patients had no humeral head migration. Of the 18 patients whose flap was examined by magnetic resonance imaging, 15 had no tear and 12 had a flap signal of muscle intensity; mean flap thickness was 5 mm. Pre-operative factors associated with poorer outcomes were upwards humeral head migration with a subacromial space smaller than 6 mm, presence of glenohumeral osteoarthritis, and supraspinatus amyotrophy greater than 40%. Deltoid flap reconstruction is a valid option in this patient population.

Nous avons examiné les dossiers de 29 malades agés de moins de 65 ans traités par lambeau deltoïdien de la rupture massive postéro-superieure de la coiffe des rotateurs. Toutes les ruptures ont impliqué les tendons supraspinatus et infraspinatus et ont été associées avec une rétractation des extrémités tendineuses à la glène, un long tendon du biceps conservable, et un tendon du muscle subscapularis intact. Le suivi moyen était de 10,5 années. Le taux de satisfaction des malades était de 89%. Le score moyen de Constant a été amélioré de 43 à 71,5 points, le score de la douleur de 6,3 à 13,2, la flexion moyenne antérieure de 100° à 157°, et la force d’élévation de 2,3 kg à 3 kg. Deux tiers des malades n’avaient aucune migration de la tête humérale. Des 18 malades dont le lambeau a été examiné par l’image de résonance magnétique, 15 n’avaient aucune rupture et 12 avaient un signal du lambeau d’intensité musculaire; l’épaisseur moyenne du lambeau était 5 mm. Les facteurs préopératoires associés avec les résultats plus médiocres étaient: migration vers le haut de la tête humérale avec un espace subacromial inférieur à 6 mm, présence d’arthrose glènohumérale, et amyotrophie du muscle supraspinatus de plus de 40%. La reconstruction par lambeau deltoïdien est une bonne option dans cette population de malade.

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Figures

Fig. 1
Fig. 1
a Schematic drawing of the shoulder region seen from the side. The dotted line represents the superior and external surgical approach. b Schematic drawing of the shoulder region seen from above. The dotted line represents the contour of the deltoid flap. c The deltoid flap sutured to the trimmed edges of the rotator cuff tear. S Scap; m subscapularis; S.E., m supraspinatus; SS.E, m infraspinatus; Pt.Rond, m teres minor
Fig. 2
Fig. 2
Post-operative magnetic resonance imaging (MRI) of the shoulder. Sagittal T2-weighted image showing a signal of muscle intensity from the deltoid flap
See this image and copyright information in PMC

References

    1. Adolfsson Int Orthop. 1993;17:228. - PubMed
    1. Aoki J Bone Joint Surg Br. 1996;78:761. - PubMed
    1. Augereau Rev Chir Orthop Reparatrice Appar Mot. 1988;74:298. - PubMed
    1. Bruns Int Orthop. 1997;21:157. doi: 10.1007/s002640050140. - DOI - PMC - PubMed
    1. Constant Clin Orthop. 1987;214:160. - PubMed