A study for evaluating the effect of the deltoid-flap repair in massive rotator cuff defects.
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.
Spahn
Gunter
G
Clinic of Traumatology and Orthopaedic Surgery, Sophienstrasse 16, 99817, Eisenach, Germany. spahn.esa@t-online.de
Kirschbaum
Stefan
S
Klinger
Hans Michael
HM
D000174:Acromion / Q000601:surgery; D000368:Aged; D001182:Arthroscopy; D001415:Back; D002968:Clavicle / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D010147:Pain Measurement; D017060:Patient Satisfaction; D016059:Range of Motion, Articular / Q000502:physiology; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D013524:Surgical Flaps; D013710:Tendons / Q000637:transplantation; D016896:Treatment Outcome