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Journal of Orthopaedic Trauma Apr 2022
Topics: Deltoid Muscle; Humans; Shoulder Fractures
PubMed: 35298448
DOI: 10.1097/BOT.0000000000002108 -
JBJS Reviews Jul 2017
Review
Topics: Axilla; Brachial Plexus; Brachial Plexus Neuropathies; Deltoid Muscle; Humans; Muscle Weakness; Paralysis; Postoperative Complications; Shoulder
PubMed: 28671874
DOI: 10.2106/JBJS.RVW.16.00061 -
JBJS Case Connector 2020We present the unique case of deltoid and hand compartment syndrome in a young man after prolonged syncope because of polysubstance use. The patient was subsequently... (Review)
Review
CASE
We present the unique case of deltoid and hand compartment syndrome in a young man after prolonged syncope because of polysubstance use. The patient was subsequently treated with urgent deltoid and hand compartment fasciotomies which resulted in full recovery of his shoulder function.
CONCLUSIONS
Patients suspected of deltoid compartment syndrome should have a thorough physical examination, followed by repeat examinations. Invasive compartment monitoring should be used in equivocal cases, in patients with decreased level of consciousness, and in patients with distracting injury. Once diagnosed, deltoid compartment syndrome (± other compartments) should be taken for emergent fasciotomy, ensuring adequate decompression of all 3 deltoid compartments.
Topics: Adult; Compartment Syndromes; Deltoid Muscle; Fasciotomy; Hand; Humans; Male; Substance-Related Disorders; Syncope
PubMed: 32044784
DOI: 10.2106/JBJS.CC.19.00289 -
Orthopedics Mar 2017Operative fixation of medial malleolar fractures, whether isolated or in the setting of bi- or trimalleolar fractures, remains controversial. Increasingly, anatomic... (Review)
Review
Operative fixation of medial malleolar fractures, whether isolated or in the setting of bi- or trimalleolar fractures, remains controversial. Increasingly, anatomic reduction and internal fixation is used to treat medial malleolar fractures to avoid long-term sequelae of symptomatic nonunion and posttraumatic osteoarthritis. However, outcomes have not been significantly different between operative and nonoperative cohorts. Repair of associated deltoid ligament disruption is not common because of reportedly poor outcomes. This review provides an overview of the literature on medial malleolar fracture fixation and current treatment options. [Orthopedics. 2017; 40(2):e216-e222.].
Topics: Ankle Fractures; Deltoid Muscle; Fracture Fixation; Humans; Ligaments; Osteoarthritis
PubMed: 27992638
DOI: 10.3928/01477447-20161213-02 -
Journal of Shoulder and Elbow Surgery Feb 2021The rotator cuff (RC) and the deltoid muscle are 2 synergistic units that enable the functionally demanding movements of the shoulder. A number of biomechanical studies...
BACKGROUND
The rotator cuff (RC) and the deltoid muscle are 2 synergistic units that enable the functionally demanding movements of the shoulder. A number of biomechanical studies assume similar force contribution of the force couple (RC and deltoid) over the whole range of motion, whereas others propose position-dependent force distribution. There is a lack of in vivo data regarding the deltoid's contribution to shoulder flexion and abduction strength. This study aimed to create reliable in vivo data quantifying the deltoid's contribution to shoulder flexion and abduction strength throughout the range of motion.
METHODS
Active range of motion and isometric muscle strength of shoulder abduction and flexion in 0°, 30°, 60°, 90°, and 120° of abduction/flexion as well as internal and external rotation in 0° and 90° of abduction were obtained in 12 healthy volunteers on the dominant arm before and after an ultrasound-guided isolated axillary nerve block. Needle electromyography was performed before and after the block to confirm deltoid paralysis. Radiographs of the shoulder and an ultrasonographic examination were used to exclude relevant shoulder pathologies.
RESULTS
Active range of motion showed a minimal to moderate reduction to 94% and 88% of the preintervention value for abduction and flexion. Internal and external rotation amplitude was not impaired. The abduction strength was significantly reduced to 76% at 0° (P = .002) and to 25% at 120° (P < .001) of abduction. The flexion strength was significantly reduced to 64% at 30° (P < .001) and to 30% at 120° (P < .001) of flexion. The strength reduction was linear, depending on the flexion/abduction angle. The maximal external rotation strength showed a significant decrease to 53% in 90° (P < .001) of abduction, whereas in adduction no strength loss was observed (P = .09). The internal rotation strength remained unaffected in 0° and 90° of abduction (P = .28; P = .13).
CONCLUSION
The deltoid shows a linear contribution to maximal shoulder strength depending on the abduction or flexion angle, ranging from 24% in 0° to 75% in 120° of abduction and from 11% in 0° to 70% in 120° of flexion, respectively. The overall contribution to abduction strength is higher than to flexion strength. The combination of deltoid muscle and teres minor contributes about 50% to external rotation strength in 90° of abduction. The internal rotation strength is not influenced by a deltoid paralysis. This study highlights the position-dependent contribution of the shoulder muscles to strength development and thereby provides an empirical approach to better understand human shoulder kinematics.
Topics: Biomechanical Phenomena; Deltoid Muscle; Humans; Range of Motion, Articular; Rotation; Rotator Cuff; Shoulder; Shoulder Joint
PubMed: 32540315
DOI: 10.1016/j.jse.2020.05.023 -
Sportverletzung Sportschaden : Organ... Mar 2022The deltoid is a large triangular muscle at the shoulder. It attaches proximally to the clavicle, acromion and scapula, while distally it attaches to the lateral deltoid...
BACKGROUND
The deltoid is a large triangular muscle at the shoulder. It attaches proximally to the clavicle, acromion and scapula, while distally it attaches to the lateral deltoid tuberosity. Ruptures are rare, and the literature only reports cases of proximal detachment. In this article, we report the first case of distal traumatic deltoid muscle detachment and its successful management.
CASE
A young female sustained a traumatic injury following a Jet Ski accident with loss of consciousness. A complete distal rupture of the deltoid muscle was diagnosed after the basic functions were regained and a thorough musculoskeletal examination could be conducted. A conservative approach helped her to regain an acceptable shoulder function, but there was persistent pain upon activity and cosmetic scarring. The patient underwent surgical reconstruction. Postoperatively, she recovered satisfactorily.
DISCUSSION
Distal detachment of the deltoid muscle is rare. The choice for surgical treatment may be undertaken based on several factors including functional status and patient-based assessment.
Topics: Deltoid Muscle; Female; Humans; Rupture; Shoulder
PubMed: 32663898
DOI: 10.1055/a-1113-1546 -
The Journal of Hand Surgery Apr 2011Several surgical techniques exist for restoring triceps function in tetraplegic patients. The goal is to establish a more synchronized, better controlled arm that allows... (Review)
Review
Several surgical techniques exist for restoring triceps function in tetraplegic patients. The goal is to establish a more synchronized, better controlled arm that allows increased self-sufficiency and further reconstructive surgery on the hand. To obtain the most secure fixation, adjust the tension, and allow early mobilization, the technique we prefer uses the central tendon of the triceps muscle and bony block fixation reinforced by the palmaris longus.
Topics: Arm; Deltoid Muscle; Elbow Joint; Female; Humans; Male; Muscle Strength; Muscle, Skeletal; Quadriplegia; Plastic Surgery Procedures; Recovery of Function; Risk Assessment; Tendon Transfer; Treatment Outcome
PubMed: 21463732
DOI: 10.1016/j.jhsa.2011.01.027 -
Skeletal Radiology Oct 2021To describe the MRI features of deltoid tears and to evaluate tear characteristics in patient groups based on history of trauma and rotator cuff tear (RCT).
OBJECTIVE
To describe the MRI features of deltoid tears and to evaluate tear characteristics in patient groups based on history of trauma and rotator cuff tear (RCT).
MATERIALS AND METHODS
The records of patients who underwent shoulder MRI at our institution between July 2007 and June 2018 were retrospectively reviewed to identify deltoid tears, and patients were divided into groups based on history of recent trauma and presence of RCT. Images were reviewed to identify the location and size of the deltoid tear; the presence or absence of RCT, muscle atrophy, tendon retraction, humeral head subluxation, soft tissue edema, and additional pathologies were also noted. Medical records were reviewed for information about history of steroid injection, previous rotator cuff surgery, and treatments used.
RESULTS
Among 69 patients with deltoid tears (45 men; mean age, 65.2 years; range, 19-89 years), patients with RCTs and no trauma had the highest frequency of deltoid tears in the middle portion (p = 0.005). Only patients with RCTs had undergone steroid injection or rotator cuff surgery. Two patients had deltoid tear without RCT and without recent trauma; these patients demonstrated evidence of calcific tendinopathy and chronic subacromial-subdeltoid bursitis.
CONCLUSION
The middle (acromial) portion of the deltoid is more frequently affected in patients with RCTs than in those with trauma. Although deltoid tears are commonly associated with RCT, calcific tendinopathy and chronic bursitis may also be seen in patients with deltoid tears.
Topics: Aged; Deltoid Muscle; Humans; Magnetic Resonance Imaging; Male; Rotator Cuff; Rotator Cuff Injuries; Tendons
PubMed: 33661326
DOI: 10.1007/s00256-021-03727-6 -
European Journal of Orthopaedic Surgery... May 2018Deltoid palsy is a classical contraindication for reverse shoulder arthroplasty (RSA). However, in cases associating axillary nerve palsy and rotator cuff tear or... (Review)
Review
Deltoid palsy is a classical contraindication for reverse shoulder arthroplasty (RSA). However, in cases associating axillary nerve palsy and rotator cuff tear or glenohumeral arthritis, few options remain. We present a case in which combining RSA with transfer of the pectoralis major and upper and middle trapezius transfer provided satisfactory results in a patient suffering of both an irreparable rotator cuff tear and a deltoid palsy.Level of evidence IV.
Topics: Aged; Arthroplasty, Replacement, Shoulder; Axilla; Deltoid Muscle; Humans; Male; Paralysis; Range of Motion, Articular; Rupture; Trauma, Nervous System; Treatment Outcome
PubMed: 29372328
DOI: 10.1007/s00590-018-2126-x -
European Journal of Orthopaedic Surgery... Feb 2022Reverse shoulder arthroplasty (RSA) leads to medialization and distalization of the centre of rotation of the shoulder joint resulting in lengthening of the deltoid...
INTRODUCTION
Reverse shoulder arthroplasty (RSA) leads to medialization and distalization of the centre of rotation of the shoulder joint resulting in lengthening of the deltoid muscle. Shear wave ultrasound elastography (SWE) is a reliable method for quantifying tissue stiffness. The purpose of this study was to analyse if deltoid muscle tension after RSA correlates with the patients' pain level. We hypothesized that higher deltoid muscle tension would be associated with increased pain.
MATERIAL AND METHODS
Eighteen patients treated with RSA were included. Constant score (CS) and pain level on the visual analogue scale (VAS) were analysed and SWE was performed on both shoulders. All three regions of the deltoid muscle were examined in resting position and under standardized isometric loading.
RESULTS
Average patient age was 76 (range 64-84) years and average follow-up was 15 months (range 4-48). The average CS was 66 points (range 35-89) and the average pain level on the VAS was 1.8 (range 0.5-4.7). SWE revealed statistically significant higher muscle tension in the anterior and middle deltoid muscle region in patients after RSA compared to the contralateral non-operated side. There was a statistically significant correlation between pain level and anterior deltoid muscle tension.
CONCLUSION
SWE revealed increased tension in the anterior and middle portion of the deltoid muscle after RSA in a clinical setting. Increased tension of the anterior deltoid muscle portion significantly correlated with an increased pain level. SWE is a powerful, cost-effective, quick, dynamic, non-invasive, and radiation-free imaging technique to evaluate tissue elasticity in the shoulder with a wide range of applications.
LEVEL OF EVIDENCE
Diagnostic study, Level III.
Topics: Arthroplasty, Replacement, Shoulder; Child; Child, Preschool; Deltoid Muscle; Elasticity Imaging Techniques; Humans; Muscle Tonus; Pain; Range of Motion, Articular; Shoulder; Shoulder Joint
PubMed: 33884494
DOI: 10.1007/s00590-021-02987-1