A study for evaluating the effect of the deltoid-flap repair in massive rotator cuff defects

Abstract

The repair of massive cuff defects by direct suture often is impossible. In these cases, a repair by musculo-tendineous flaps (latissimus-dorsi, pectoralis or deltoideus) is required. It was the goal of this study to evaluate the result of delta-flap repair in case of massive cuff defects with a diameter of 5 cm or more. Between 1998 and 2000 for all patients who were suffering from a massive rotator cuff tear more than 5 cm a deltoid transfer was performed. A total of 20 patients (14 male, 6 female; age: 60.9+/-8.7 years) were available for a follow-up after 47.2+/-8.0 (range, 36 to 60) month. The operation included an arthroscopic evaluation, acromioplasty with resection of the lateral clavicular end, and biceps tenodesis. The cuff defect was repaired by transfer a muscular flap from the anterior part of the deltoid (about 2 x 6 cm) into the defect. The patients subjectively rated their result-10 excellent, 9 good, and 1 poor. Preoperatively, the Constant amounted 26.3+/-5.1 points. At follow-up, the score significantly increased to 74.5+/-8.5 points. The acromiohumeral distance increased from 4.9+/-1.1 to 9.2+/-1.7 mm. In MRI examination of 11 patients all had an intact flap. Two complications (a wound hematoma and a deep infection) did not influence the result. The repair of massive rotator cuff tears by a deltoid transfer produces acceptable clinical and radiological results.

Rotator cuff tears treated with a modified deltoid flap repair technique

“…With the current study, this issue could not be answered. Similar findings of improvement of function were described in other series of deltoid flap repair, 5,14,32,37,43,47 in contrast to Glanzmann et al, 27 who described only a minor functional gain in their series. In our study, factors that were associated with lower flexion scores included tear size (which means tears involving 3 tendons), and fatty infiltration of the subscapularis muscle.…”

“…This observation corresponds to other series of deltoid flap procedures that also showed high rates of pain relief. 5,14,21,32,37,43,47 Flexion above 150 was obtained in 61% of the cases and flexion above 90 in 93% of the cases. Of the 19 patients who could not elevate their arms above 90 before surgery, 18 had improvement of their function.…”

Surgical Technique: Transfer of the Anterior Portion of the Gluteus Maximus Muscle for Abductor Deficiency of the Hip

“…Surgeons have treated chronic avulsion of the patellar tendon and loss of extensor power of the knee effectively with gastrocnemius muscle transfer [3]. Chronic rotator cuff avulsion responds well to latissimus dorsi and deltoid muscle transfer [12]. The gluteus maximus muscle is convenient and effective when covering soft tissue defects about the pelvis [2,8,10].…”

The use of split deltoid-flap in the treatment of massive rotator cuff defects: a retrospective study of 61 patients

“…There are relatively few reports in international literature that have examined the functional outcome of the [5,38].…”