[Adult cases of the deltoid contracture--survey and analysis of seven cases experienced and forty cases previously reported in literature].

The deltoid contracture developing in adulthood is rare. The author analyzed his seven cases with at least two year's follow-up and forty reported cases in Japanese and English literature. It was found that most clinical features except in some were common to adult and child cases. In adult cases, both shoulders were involved frequently, whereas most of child cases were unilateral, especially on the left. Pain was noted in all cases in the neck, shoulder and lateral aspect of the upper arm. On the contrary, child cases were characterized by the absence of pain. The symptoms of the child cases worsened in the course of the process, but those of the adult cases became fixed within at least 4 years after the onset. The cause of this condition is almost always from the multiple intramuscular injections in both categories. In some of adult cases, patients addict themselves to injections and result in heavy contracture. The kind and amount of the drug inducing this condition are very variable. Consequently, the safety dose for intramuscular injection can not be determined. Even to adults, multiple intramuscular injections to one muscle should be avoided. Operative treatment is indicated, as conservative treatment is not effective. The resection of fibrous portions constantly give relief of symptoms and good function. Occasionally, the advancement of posterior and/or anterior deltoid is required after resection.