Irreparable spontaneous deltoid rupture in rotator cuff arthropathy: the use of a reverse total shoulder replacement

Tay, Aaron

doi:10.1016/j.jse.2011.03.013

Cited by 17 publications

(11 citation statements)

References 9 publications

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“…As such, it has been proposed that underlying RCTs can disrupt the intrinsic shoulder dynamics and lead to an atraumatic rupture of the deltoid muscle [ 4 , 5 , 9 , 12 ]. Despite these theoretical concerns, to our knowledge, only 7 atraumatic deltoid ruptures are confirmed in the literature [ 2 – 4 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Atraumatic Deltoid Rupture with a Chronic Massive Rotator Cuff Tear: A Case Report and Surgical Technique

Alben

Gambhir

Boin

et al. 2022

Case Reports in Orthopedics

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Case. We report a rare case of a spontaneous, atraumatic rupture of the anterior and middle heads of the deltoid with an underlying massive rotator cuff tear. Unique clinical findings included a palpable mass of torn deltoid distally with a proximal tissue defect. Magnetic resonance imaging of the deltoid demonstrated complete tear of the anterior head; involvement of the middle head was found intraoperatively. Given the acute nature of injury and potential impact on the feasibility of future reverse shoulder arthroplasty, surgical repair of the torn deltoid was discussed with the patient and performed via superior approach. Conclusion. Direct surgical repair is a viable treatment option if diagnosed early.

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Section: Discussionmentioning

confidence: 99%

“…The available literature on deltoid ruptures is relatively sparse, but does include reports of these ruptures in the setting of an existing RCT [ 2 – 4 , 11 ]. Ilaslan et al and Colak et al reported a review based on imaging of this injury.…”

Section: Discussionmentioning

confidence: 99%

Atraumatic Deltoid Rupture with a Chronic Massive Rotator Cuff Tear: A Case Report and Surgical Technique

Alben

Gambhir

Boin

et al. 2022

Case Reports in Orthopedics

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“…Reverse shoulder arthroplasty has been used for massive rotator cuff tears; however, deltoid dysfunction is considered to be a contraindication and precludes its use. On the other hand, there is a report that shows a satisfactory result 2 years postoperatively after reverse shoulder arthroplasty in a patient suffering from a deltoid rupture and rotator cuff tear arthropathy in the absence of superior shoulder dislocation [11]. In addition, it has also been reported that reverse shoulder arthroplasty associated with repair of the deltoid was performed in 18 elderly patients with massive irreparable rotator cuff tears and associated rupture of the anterior and middle deltoid muscle, and that satisfactory clinical outcomes were achieved in the medium term, except for the patients with preoperative chronic axillary nerve neuropathy [12].…”

Section: Discussionmentioning

confidence: 99%

Posterosuperior shoulder dislocation due to the rupture of deltoid posterior fibers: a case report

Furuhata

Kiyota

Ikeda

et al. 2019

BMC Musculoskelet Disord

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Background Superior shoulder dislocation is a rare type of shoulder dislocation. Its occurrence is thought to be associated with rupture of the deltoid; however, few reports are available on the mechanism of onset and the treatment of a superior shoulder dislocation. Here we describe a case of dislocation in the direction of the posterior acromion, referred to as posterosuperior shoulder dislocation, caused by the traumatic rupture of deltoid posterior fibers. Case presentation An 83-year-old woman who fell on her right elbow in the hospital presented to our department with complaints of right shoulder pain. She had been undergoing conservative treatment for a massive rotator cuff tear and a rupture of the long head of biceps tendon 5 years previously. X-ray radiography images at the time of the trauma revealed that the right humeral head was dislocated upwards and in the direction of the posterior acromion. Magnetic resonance imaging (MRI) revealed newly ruptured deltoid posterior fibers, in addition to the massive rotator cuff tear. Closed reduction was performed and the shoulder joint was held in external rotation at 30 degrees for 6 weeks. However, re-dislocation was observed at an early stage after the removal of the orthosis and marked instability remained. Conclusions This is the first case of posterosuperior shoulder dislocation. It suggests that rupture of the deltoid posterior fibers contributes to the onset of posterosuperior shoulder dislocation in patients with a massive rotator cuff tear. Moreover, in superior shoulder dislocation, conservative treatment may result in continuing instability which requires surgical treatment.

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“…Groh described a series of 36 patients with deltoid deficiency after various shoulder operations, of which 25 had loss of the anterior or anterior and middle heads; 28 reported fair or poor shoulder function as determined by activities of daily living [9]. Tay reported on one case of rTSA for CTA and concurrent irreparable middle deltoid avulsion with good outcome [10]. Schneeberger performed rTSA on 19 patients who failed deltoid flap reconstruction for irreparable rotator cuff tears.…”

Section: Case Reportmentioning

confidence: 99%

Custom Reverse Total Shoulder Arthroplasty

Grisez¹,

Goodman²,

Lindsey³

2017

J Cancer Sci Ther

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Reverse total shoulder arthroplasty (rTSA) initially faltered because of glenoid component failure. Modern design utilizes a large glenosphere component and relies upon a functional deltoid for arm elevation. We report novel use of rTSA to revise a chronically dislocating TSA. The patient underwent proximal humeral resection for chondrosarcoma, requiring sacrifice of the deltoid and all proximal insertions including the latissimus dorsi. Twoyears post-operatively, he had good stability, no pain, and was using his arm more than he had in years. rTSA is a salvage option for failed TSA, even with absent deltoid function and lack of a latissimus.

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Irreparable spontaneous deltoid rupture in rotator cuff arthropathy: the use of a reverse total shoulder replacement

Cited by 17 publications

References 9 publications

Atraumatic Deltoid Rupture with a Chronic Massive Rotator Cuff Tear: A Case Report and Surgical Technique

Atraumatic Deltoid Rupture with a Chronic Massive Rotator Cuff Tear: A Case Report and Surgical Technique

Posterosuperior shoulder dislocation due to the rupture of deltoid posterior fibers: a case report

Custom Reverse Total Shoulder Arthroplasty

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