Surgical results of concomitant treatment of deltoid contracture and rotator cuff tear

Background

Contracture of the deltoid muscle is an uncommon disorder. The symptoms usually are nonspecific and the diagnosis may be missed, especially when combined with other shoulder disorders, such as rotator cuff lesions. Few reports have described the surgical treatment of combined deltoid contracture and a torn rotator cuff. The purpose of this study was to share our experiences in the diagnosis and treatment of patients, who sustained deltoid contracture combined with rotator cuff tearing.

Materials and methods

Between April 2001 and December 2006, 18 consecutive patients underwent concomitant treatment for distal release of deltoid contracture and repair of a torn rotator cuff. The mean age at operation was 55.1 years. There were eight female and ten male patients. The acromial type, winging angle of the scapula and thickest diameter of the deltoid fibrotic band were measured using preoperative magnetic resonance imaging studies. The abduction-contracture angle, extension-contracture angle, horizontal-adduction angle and Constant and Murley scores were measured preoperatively and at the latest follow-up.

Results

There were nine complete rotator cuff tears and nine partial tears. At an average of 5 years and 3 months’ follow-up, the mean abduction-contracture angle significantly improved from 27° to 0° (p < 0.001), the mean extension-contracture angle improved from 13° to 0° (p < 0.001), and, the mean horizontal-adduction angle improved from 8° to 44° (p < 0.001). The mean Constant score also improved from 69 points to 95 points (p < 0.001).

Conclusions

If a symptomatic torn rotator cuff and deltoid contracture co-exist, simultaneous operative treatment of both conditions is highly recommended.