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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 6, 757-763.
doi: 10.1302/0301-620X.90B6.19804  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Pectoralis major inverse plasty for functional reconstruction in patients with anterolateral deltoid deficiency

H. Resch, MD, Trauma Surgeon, Professor, Head of Department1; P. Povacz, MD, Trauma Surgeon1; H. Maurer, MD, Anatomist, Associate Professor2; H. Koller, MD, Trauma Surgeon1; and M. Tauber, MD, Trauma Surgeon1

1 Department of Traumatology and Sports Injuries University Hospital of Salzburg, Muellner Hauptstrasse 48, 5020 Salzburg, Austria.
2 Institute of Anatomy, University Hospital of Innsbruck, Muellerstrasse 59, 6020 Innsbruck, Austria.

Correspondence should be sent to Dr. M. Tauber; e-mail: m.tauber{at}salk.at

After establishing anatomical feasibility, functional reconstruction to replace the anterolateral part of the deltoid was performed in 20 consecutive patients with irreversible deltoid paralysis using the sternoclavicular portion of the pectoralis major muscle. The indication for reconstruction was deltoid deficiency combined with massive rotator cuff tear in 11 patients, brachial plexus palsy in seven, and an isolated axillary nerve lesion in two. All patients were followed clinically and radiologically for a mean of 70 months (24 to 125). The mean gender-adjusted Constant score increased from 28% (15% to 54%) to 51% (19% to 83%). Forward elevation improved by a mean of 37°, abduction by 30° and external rotation by 9°.

The pectoralis inverse plasty may be used as a salvage procedure in irreversible deltoid deficiency, providing subjectively satisfying results. Active forward elevation and abduction can be significantly improved.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General