Deltoid flap reconstruction for massive rotator cuff tears: mid- and long-term functional and structural results.
BACKGROUND
Various open and arthroscopic techniques for irreparable massive rotator cuff tears have been described. Muscle-tendon transfers may be considered in order to improve range of motion and strength.


METHODS
We assessed retrospectively the functional and structural results of 31 deltoid flap transfers for massive postero-superior rotator cuff tears at 2 time points: Mid- and long-term follow-up exams were performed after a mean of 53 and 175 months, respectively.


RESULTS
Functional gains were minor, but improvement in pain and patient satisfaction was high. The mean Constant score improved from 31 preoperatively to 46 points at mid-term follow-up. At long-term follow-up, 16 shoulders were still available for exam and presented with a mean Constant score of 66 points. Survival rates of the deltoid flap, confirmed by ultrasound, were 16.5% at mid-term and 12.5% at long-term follow-up, and correlated with better clinical outcome. Cranial migration of the humeral head progressed in all cases and could not be prevented by the interposition of a deltoid flap.


CONCLUSIONS
Based on the results of this series, we no longer use nor recommend this technique.
Glanzmann
Michael C
MC
Schulthessclinic, Upper Extremity Group, Zürich, Switzerland. mcglanzmann@sunrise.ch
Goldhahn
Jörg
J
Flury
Matthias
M
Schwyzer
Hans-Kaspar
HK
Simmen
Beat R
BR
D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000601:surgery; D013524:Surgical Flaps; D013708:Tendon Injuries / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome