title: Rotator cuff tears treated with a modified deltoid flap repair technique.
abstract: BACKGROUND
  Few options exist in the treatment of irreparable rotator cuff tears, especially in younger patients. The purpose of this study was to present our experience with deltoid flap repairs combined with acromion elevation osteotomy increasing the space for the flap.
  
  
  METHODS
  We retrospectively reviewed the outcome of 57 patients with a mean age of 60 years who had undergone the modified anterolateral deltoid flap technique for the treatment of large and massive rotator cuff tears. Follow-up was performed after a mean of 6 years.
  
  
  RESULTS
  At follow-up, 84% of patients considered the condition of their shoulder as better or much better compared with before surgery. The mean Constant score was 88% (range, 45-122). Before surgery, all shoulders were significantly painful. At latest follow-up, 91% of the patients had no or mild pain. Elevation of the arm above 90° was possible in 38 patients before surgery and in 53 patients at latest follow-up. Tears involving 3 tendons were associated with inferior results. Retears of the deltoid flap occurred in 8 patients (14%); 1 of them was successfully treated with a reverse total shoulder replacement, and 6 had a repair of the flap, with only 1 satisfactory outcome.
  
  
  CONCLUSIONS
  The modified deltoid flap yielded reliable pain relief and a high rate of patient satisfaction, as well as satisfactory function in the majority of the patients. Especially in younger patients, this technique might be considered a viable alternative for the treatment of irreparable rotator cuff tears.
authors: Endoclinic Zurich, Klinik Hirslanden, Zurich, Switzerland. ags@schulter-ellbogen.ch
authors: Alberto G
authors: AG
authors: Schneeberger
authors: Lisa
authors: L
authors: Schuler
authors: Daniel
authors: D
authors: Rikli
authors: Christoph
authors: C
authors: Thür
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D057645:Deltoid Muscle / Q000601:surgery*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D022125:Lacerations / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000175:diagnosis / Q000601:surgery; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome