Langzeitergebnisse (5 - 13 Jahre) nach lokaler Rekonstruktion und Deltoideuslappenplastiken bei massiven Rotatorenmanschettendefekten

Td, Boehm; A, Ilg; Werner, A.; Kirschner, S.; Gohlke, Frank

doi:10.1055/s-2004-817657

Cited by 11 publications

(6 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It was then independently developed by Apoil and Augereau [2] who also performed this surgery on a large number of patients and popularized this transfer. Literature results on this method is controversial, as some authors report good to excellent results, while others report poor results, due to flap rerupturing or necrosis [4, 7, 12, 15, 26, 37, 38, 40].…”

Section: Introductionmentioning

confidence: 99%

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

Hadjicostas

Soucacos²,

Theissen

et al. 2008

Knee Surg Sports Traumatol Arthr

View full text Add to dashboard Cite

Massive and irreparable rotator cuff tears are a challenge for the orthopaedic surgeon. The purpose of this study was to report our experience with the treatment of massive and irreparable defects of the rotator cuff with a modified deltoid split transfer. Between 1996 and 2004, for all patients suffering from full-thickness tears of the rotator cuff (> 5 cm tears in diameter, involving two or more tendons) were operated with a modified deltoid split transfer. A total of 61 patients (39 females and 22 males; age 61.9: range 49-75 years) were operated. Duration of symptoms before surgery averaged 9.6 months (range 3.5-14 months). The patients were followed for an average of 46 months (range 24-64 months). The operation included an arthroscopic evaluation, acromioplasty with resection of the lateral clavicular end, resection of the acromioclavicular joint and where necessary biceps tenodesis. The cuff defect was repaired by transfer of half thickness anterior deltoid-flap (3 cm x 5 cm) into the defect. All patients were evaluated both preoperatively and postoperatively with regard to pain, ability to perform activities of daily life, range of motion, strength and satisfaction. The patients subjectively rated their results--49 (80%) excellent or good outcome, seven moderate and five poor. Preoperatively, the Constant amounted 33.5 +/- 7.74 points. At follow-up, the score significantly increased to 77.57 +/- 19.74 points. The acromiohumeral distance increased from 5.1 +/- 1.4 mm to 9.1 +/- 1.5 mm. Pain free flexion improved from an average 90 degrees to an average 165 degrees (P < 0.01), and abduction improved from an average 110 degrees to an average 160 degrees (P < 0.01). The mean external rotation increased from 40 degrees to 65 degrees (P < 0.01), and internal rotation increased from 50 degrees to 70 degrees (P = 0.06). In the MRI and ultrasound examination, all patients had intact flap, except the three patients with flap necrosis. There were eight complications--three haematomas, two superficial wound infections which did not influence the outcome, and three fibrotic transformation after an early aseptic necrosis of the deltoid flap, which were re-operated. This technique is easy to perform, and it is possible to obtain a satisfactory outcome after repair of massive tears of the rotator cuff. A substantial decrease of pain, increased stability, an increase range of motion and strength can be achieved, with proper rehabilitation.

show abstract

Section: Introductionmentioning

confidence: 99%

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

Hadjicostas

Soucacos²,

Theissen

et al. 2008

Knee Surg Sports Traumatol Arthr

View full text Add to dashboard Cite

show abstract

“…This method is relatively easy in performing and produces excellent or good results [12, 34, 38]. On the other hand, there are reports with poor results after delta‐muscle‐flap repair [5, 10].…”

Section: Introductionmentioning

confidence: 99%

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

Spahn¹,

Kirschbaum²,

Klinger

2005

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

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.

show abstract

“…Die ermittelten Punktwerte wurden geschlechts-und altersadaptiert berechnet. Maximal werden 100 Punkte erreicht, was durch die Geschlechts-und Altersadaptation überschritten werden kann [7].…”

Section: Op-methodeunclassified

“…In der eigenen Nachuntersuchung war die Kraft der operierten Seite geringer als die Kraft der Gegenseite, wobei auch in den Altersgruppen von A0 nach A3 abnehmend die Kraft der Gegenseite höher gemessen wurde. In der Literatur sind Angaben zur Inzidenz der Rerupturen nach Rekonstruktion der Rotatorenmanschette bis 37% [7,14,16,23,25,34,35,46] zu finden. Die Problematik in der operativen Rekonstruktion der Rotatorenmanschette im höheren Lebensalter liegt im degenerativen Vorschaden mit verminderter Sehnenqualität.…”

Section: Dash-scoreunclassified

Subjektives und klinisches Outcome nach Rekonstruktion der Rotatorenmanschette im höheren Lebensalter

Kilián

Balser²,

Heiß³

et al. 2008

Z Orthop Unfall

View full text Add to dashboard Cite

show abstract

Langzeitergebnisse (5 - 13 Jahre) nach lokaler Rekonstruktion und Deltoideuslappenplastiken bei massiven Rotatorenmanschettendefekten

Cited by 11 publications

References 20 publications

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

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

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

Subjektives und klinisches Outcome nach Rekonstruktion der Rotatorenmanschette im höheren Lebensalter

Contact Info

Product

Resources

About