[Diagnosis and treatment of deltoid contracture in children].
OBJECTIVE
To reinforce the recognization of deltoid contracture in children and probe its causes, pathomechanism, diagnosis and treatments.


METHODS
The Clinical data were summarized and analysed, including etiological factors, clinical situations, examinations and treatments from 9 child patients with deltoid contracture from 1992 to 2004. The 9 child patients were followed up to evaluate therapeutic efficacy.


RESULTS
Nine child patients with deltoid contracture included 4 boys and 5 girls, who aged from 5 to 14 years. The main clinical features were presented as abductive deformity, limitation of adduction of the shoulder, winging of the scapula, and dimpling of the skin with a palpable fibrous hard band in deltoid muscle. Four cases had a history of intramuscular injections in deltoid and 1 case was accompanied with bilateral gluteul contracture. Among the 9 patients, 8 cases were misdiagnosed before correct diagnosis and treatment. The misdiagnosis rate was up to 90%. All the cases received the operative treatments to release fibrous bands and were followed up for 8 months to 12 years. Abductive deformity disappeared and functions of the shoulders recovered in all patients, except 1 patient who had a lightly winged scapula.


CONCLUSIONS
Deltoid contracture may be caused by multiple factors, but its clinical features are conductive to correct diagnosis and excellent therapeutic efficacy can be acquired by operation early.
Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu Sichuan 610041, P R China.
Xueyang
X
Tang
Lijun
L
Liu
Mingxing
M
Pen
Yang
Y
Yu
Jie
J
Li
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003286:Contracture / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D003951:Diagnostic Errors; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology; D012785:Shoulder Joint / Q000503:physiopathology; D017211:Treatment Failure