title: Deltoid muscular flap transfer for the treatment of irreparable rotator cuff tears.
abstract: The purpose of this study was to evaluate the outcome of deltoid muscle flap transfer for the treatment of irreparable rotator cuff tears. In a retrospective study 20 consecutive patients were evaluated. The index procedure took place between 2000 and 2003. Fifteen patients were male, mean age was 62 years. Inclusion criterion was a rotator cuff defect Bateman grade IV. Exclusion criteria were smaller defects, shoulder instability and fractures of the injured shoulder. An open reconstruction with acromioplasty and a pedicled delta flap was performed. Follow up period was mean 42 months. Follow-up included clinical examination, Magnetic Resonance Imaging (MRI) and the Constant and Simple (CS) shoulder tests. According to the Constant shoulder test the results were good in 13 patients, fair in 5 and unsatisfactory in 2. The pre-operative Constant Score improved from mean 25.7 points (±5.3) to 72.3 (±7.8) at follow-up. The mean values for the subcategories of CS increased significantly from 3.9 to 14.4 points for pain and from 4.2 to 15.9 points for activities daily routine (p<0.05). The change in range of motion and strength were not significant (p>0.05). Results of the Simple Shoulder Test showed a significant increase of the mean values from pre-operative 4.3 to 14.7 points post-operatively. MRI showed a subacromial covering of the defect in all cases, all flaps where intact on MRI but always the flap showed marked fatty degeneration. In conclusion, the delta flap is a simple method for the repair of large defects of the rotator cuff leading to satisfying medium results.
authors.affiliation: Department of Trauma and Reconstructive Surgery, University of Schleswig-Holstein, Germany;
authors.forename: Justus
authors.initials: J
authors.lastname: Gille
authors.forename: Joerg
authors.initials: J
authors.lastname: Suehwold
authors.forename: Arndt-Peter
authors.initials: AP
authors.lastname: Schulz
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kienast
authors.forename: Andreas
authors.initials: A
authors.lastname: Unger
authors.forename: Christian
authors.initials: C
authors.lastname: Jürgens