[The anterolateral deltoid muscle flap-plasty: the procedure of choice in large rotator cuff defects].

We analysed the results of shoulder reconstruction using an anterolateral deltoid muscle flap plasty in 101 patients with large rotator cuff lesions. This method was first described in Apoil and Augereau in 1985. We modified and extended their technique. Regular follow-up examinations were possible in 100 patients (27 females, 73 males, age 61.3 +/- 8.7 years). One patient died of sepsis of unknown aetiology during the hospital stay. All patients suffered from severe pain and sleepless nights prior to the operation. They also had long histories of unsuccessful and frustrating treatment. The rotator cuff lesions found intraoperatively were at least 5 x 5 cm in size. We used an anterolateral deltoid muscle flap to reconstruct these large defects. Physical therapy was started on the 1 postoperative day and was continued for about 6 months (6.8 +/- 2.6 months). The average hospital stay was 10.9 +/- 5.3 days. After the treatment 90% of all patients were subjectively satisfied or very satisfied with the result, while 12% had moderate and 5% unsatisfactory results. No pain was felt at all by 75% of the patients, and 21% showed decidedly less pain. Severe pain attacks were found in only 4% of the patients, but their pain was less intense than preoperatively. The shoulder function improved significantly, and 72% recovered their strength completely. Most of the patients were able to work after 6 months. The overall result was good to very good in 83%. This high percentage of good shoulder function and patient satisfaction makes this the operation technique of choice for large rotator cuff lesions.