Loss of the deltoid after shoulder operations: An operative disaster.

A series of 36 patients who had a postoperative loss of the anterior or anterior lateral deltoid muscle after shoulder operations (i.e., acromioplasties, anterior shoulder reconstructions, or arthroplasty procedures) was referred to the senior author. Three patients last the function of their deltoid after an injury to the axillary nerve, and 33 patients lost deltoid function after loss of the origin of the deltoid from the clavicle and acromion. All patients were significantly disabled. All patients were dissatisfied with the result of the previous operation, and eight patients experienced painful anterior or anterior/superior dislocation of the glenohumeral joint. Treatment was nonspecific and supportive. The authors conclude that loss of anterior deltoid function secondary to denervation or detachment results in irrevocable pain and impairment of function. Careful attention to the surgical technique of deltoid reattachment and protection of the axillary nerve are essential to the prevention of dire consequences to shoulder function.

[1]  V. Hentz Peripheral nerve repair and regeneration. , 1989, The Western journal of medicine.

[2]  D. Palma,et al.  Surgery of the Shoulder , 1951, The Indian Medical Gazette.

[3]  C. Neer,et al.  Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. , 1972, The Journal of bone and joint surgery. American volume.

[4]  J. Iannotti Rotator cuff disorders : evaluation and treatment , 1991 .

[5]  S. Howell,et al.  Clarification of the role of the supraspinatus muscle in shoulder function. , 1986, The Journal of bone and joint surgery. American volume.

[6]  Saha Ak SURGICAL REHABILITATION OF PARALYZED SHOULDER FOLLOWING POLIOMYELITIS IN ADULTS AND CHILDREN. , 1964 .

[7]  C. Neer,et al.  On the disadvantages of radical acromionectomy. , 1981, The Journal of bone and joint surgery. American volume.

[8]  R. Cofield,et al.  Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. , 1984, The Journal of bone and joint surgery. American volume.

[9]  G. Wolfgang,et al.  Surgical repair of tears of the rotator cuff of the shoulder. Factors influencing the result. , 1974, The Journal of bone and joint surgery. American volume.

[10]  W Z Burkhead,et al.  Surgical anatomy of the axillary nerve. , 1992, Journal of shoulder and elbow surgery.

[11]  J. Saunders,et al.  Surgical approaches to the shoulder joint. , 1949, The Journal of bone and joint surgery. American volume.

[12]  F. R. Ober AN OPERATION TO RELIEVE PARALYSIS OF THE DELTOID MUSCLE , 1932 .

[13]  C. Neer,et al.  Recent experience in total shoulder replacement. , 1982, The Journal of bone and joint surgery. American volume.

[14]  J. E. Bateman,et al.  The shoulder and neck , 1972 .

[15]  H. Ph Anterior transplantation of the posterior deltoid for shoulder palsy and dislocation in poliomyelitis. , 1947 .

[16]  J. Brown EARLY ASSESSMENT OF SUPRASPINATUS TEARS , 1949 .

[17]  H. L. Mclaughlin Rupture of the Rotator Cuff , 1962 .

[18]  S. L. Haas THE TREATMENT OF PERMANENT PARALYSIS OF THE DELTOID MUSCLE , 1935 .

[19]  C. A. Rockwood The technique of total shoulder arthroplasty. , 1990, Instructional course lectures.

[20]  E. A. Linell The Distribution of Nerves in the Upper Limb, with reference to Variabilities and their Clinical Significance. , 1921, Journal of anatomy.

[21]  H. Tullos,et al.  The axillary nerve and its relationship to common sports medicine shoulder procedures , 1986, The American journal of sports medicine.