Treatment of the Open Glenohumeral Joint with the Anterior Deltoid Muscle Flap

Abstract

Upper extremity reconstruction is most often encountered in trauma patients. Although the rate of complications from elective orthopedic procedures remains relatively low, these complications are oftentimes in the form of open joints or joint infections that can be devastating. Classically, wounds of the shoulder girdle have been treated with large muscles such as the pectoralis major, pectoralis minor, and latissimus dorsi. Flaps more local to the area including the deltoid muscle flap have been overlooked due to their small size. Despite its size, the anterior deltoid can be used for shoulder girdle reconstruction with minimal functional deficit and allows for reconstruction of the glenohumeral joint without sacrifice of the larger muscles of the upper trunk. This study reports a case of a chronic shoulder girdle wound and successful management with the use of an anterior deltoid muscle flap.

Fig. 1.

Debrided open wound with extension of the wound to access deltoid.

Fig. 2.

Tension-free movement of the anterior deltoid.

Fig. 3.

Anterior head of the deltoid transposed laterally and reattached to the lateral head of the deltoid.