0
Articles   |    
Contracture of the Deltoid Muscle. Results of Distal Release*†
JIH-YANG KO, M.D.‡; KAI-NAN AN, PH.D.§; RYUJI YAMAMOTO, M.D., PH.D.#, KAOHSIUNG, TAIWAN
View Disclosures and Other Information
Investigation performed at Chang-Gung Memorial Hospital, Kaohsiung
J Bone Joint Surg Am, 1998 Feb 01;80(2):229-38
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Abstract

We prospectively studied the results of distal release, performed between February 1989 and December 1994 for the treatment of a contracture of the deltoid muscle, in forty patients (forty-nine shoulders). Forty-seven contractures (in thirty-eight patients) developed after multiple intramuscular injections of various medications. The two remaining contractures (in two patients) were congenital. The average age at the onset of the symptoms was thirty-two years (range, birth to fifty-eight years). The primary symptoms included pain around the neck and the shoulder girdle, dimpling of the skin, a palpable fibrous band, winging of the scapula, difficulty in combing the hair or reaching the contralateral side of the body for grooming, and inability to bring the arm adjacent to the body.The average age at the time of the operation was thirty-nine years (range, fifteen to sixty-three years). The average duration of follow-up was three years and eleven months (range, two years to six years and six months). After the distal release of the contracture, but on the same day, the patients started a physical-therapy program.Postoperatively, the pain, dimpling of the skin, palpable fibrous band, and winging of the scapula resolved in forty-eight shoulders (thirty-nine patients). Six patients (six shoulders) no longer had difficulty in combing the hair or adducting the shoulder. There were no infections or neuromuscular complications. Forty-seven (96 per cent) of the forty-nine shoulders (thirty-eight of the forty patients) had a good clinical result, and two shoulders (two patients) had a poor result.Anterosuperior subluxation of the humeral head, noted on preoperative radiographs of twenty-three shoulders (eighteen patients), was not present postoperatively. Drooping of the acromion, seen in six patients (six shoulders) in whom the contracture had developed before they were sixteen years old, improved postoperatively in five shoulders (five patients). Rotation of the scapula, seen in five shoulders (five patients), resolved after release of the contracture in all five. There were no clinical or radiographic signs of osteoarthrosis due to long-term anterior translation of the shoulder joint in the four patients (six shoulders) who had had the contracture for at least twenty years (average, twenty-three years; maximum, twenty-seven years).

Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    11/15/2013
    Louisiana - Ochsner Health System
    04/16/2014
    Georgia - Choice Care Occupational Medicine & Orthopaedics
    02/28/2014
    DC - Children's National Medical Center
    03/17/2014
    CT - Orthopaedic Foundation