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Delayed surgical repair of the deltoid following acromioplasty: a case report

  • Zohaib Sherwani (Stritch School of Medicine, Loyola University) ;
  • Chase Kelley (Midwestern University Chicago College of Osteopathic Medicine) ;
  • Hassan Farooq (Department of Orthopaedic Surgery and Rehabilitation, Loyola University Health System) ;
  • Nickolas G. Garbis (Department of Orthopaedic Surgery and Rehabilitation, Loyola University Health System)
  • Received : 2021.09.24
  • Accepted : 2022.02.21
  • Published : 2022.12.01

Abstract

Currently, the literature contains few studies that describe any potential complications following arthroscopic acromioplasty. Because part of the anterior deltoid originates from the anterior acromion, there is a risk for violation and subsequent iatrogenic rupture or avulsion during this procedure. This type of injury can be a devastating problem for patients that may lead to poor function and debilitating pain. We present a patient with deltoid insufficiency following arthroscopic acromioplasty who elected to proceed with operative management with a planned arthroscopic evaluation of the shoulder followed by an open deltoid repair. At the final follow-up visit 2.5 years postoperatively, the patient reported improved pain from baseline and no residual disability and was able to perform most activities of daily living without difficulty. This case serves as an example of a surgical repair for a deltoid avulsion following arthroscopic acromioplasty. As there is still a lack of standard guidelines, our suture repair technique can be considered one method of treatment for this type of injury.

Keywords

References

  1. Elzanie A, Varacallo M. Anatomy, shoulder and upper limb, deltoid muscle. Treasure Island, FL: StatPearls Publishing; 2022.
  2. Harrison AK, Flatow EL. Subacromial impingement syndrome. J Am Acad Orthop Surg 2011;19:701-8.
  3. Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am 1972;54:41-50.
  4. Rockwood CA, Lyons FR. Shoulder impingement syndrome: diagnosis, radiographic evaluation, and treatment with a modified Neer acromioplasty. J Bone Joint Surg Am 1993;75:409-24.
  5. Vitale MA, Arons RR, Hurwitz S, Ahmad CS, Levine WN. The rising incidence of acromioplasty. J Bone Joint Surg Am 2010;92:1842-50.
  6. Cho NS, Cha SW, Rhee YG. Alterations of the deltoid muscle after open versus arthroscopic rotator cuff repair. Am J Sports Med 2015;43:2927-34.
  7. Gumina S, Di Giorgio G, Perugia D, Postacchini F. Deltoid detachment consequent to open surgical repair of massive rotator cuff tears. Int Orthop 2008;32:81-4.
  8. Yamaguchi K, Ito N, Eto M, Iwasaki K, Akeshima N. Rupture of the deltoid muscle belly with tear of the rotator cuff: a case report. Orthop Traumatol 1993;42:1663-6.
  9. Gartsman GM. Arthroscopic acromioplasty for lesions of the rotator cuff. J Bone Joint Surg Am 1990;72:169-80.
  10. Bonsell S. Detached deltoid during arthroscopic subacromial decompression. Arthroscopy 2000;16:745-8.