title: Massive tears of the rotator cuff treated with a deltoid flap.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Georges Pompidou European Teaching Hospital, Necker University, 20 Rue Le Blanc, 75908, Paris Cedex 15, France. eric.vdb@egp.ap-hop-paris.fr
authors.forename: Eric
authors.initials: E
authors.lastname: Vandenbussche
authors.forename: Moncef
authors.initials: M
authors.lastname: Bensaïda
authors.forename: Céline
authors.initials: C
authors.lastname: Mutschler
authors.forename: Thierry
authors.initials: T
authors.lastname: Dart
authors.forename: Bernard
authors.initials: B
authors.lastname: Augereau
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013524:Surgical Flaps; D016896:Treatment Outcome