Remark of the relationship between anatopathology and surgical technique for treatment of fibrous deltoid muscle in children

ABSTRACT

Background: Deltoid fibrosis is part of a spectrum of fibrous conditions that affects both function and cosmetic surgery. Objectives: Describing anatopathology injury of fibrous deltoid muscle, and evaluating relationship between pathological anatomy and surgical technique. Subject and methods: A prospective study was undertaken to evaluate the relationship between pathological anatomy and surgical technique, which were performed from April 2006 to May 2007. The study included 279 children (102 female, 177 male); age range from 5 years old to 18 years old. Clinical examination, X-ray and ultrasound techniques were performed. Patients were operated with insertion or distal fibrous portion release. Results: The dimpling of the skin, the palpable fibrous band resolved completely in all of them. Subluxation of scapula - humeral joint in 62.4%, abducent angle more than 25 degrees in 81.3%; Adduction angle more than 15 degrees in 94.5%; and Hung NN angle less than 20 degrees in 96.4%. Droop of acromion in 74% and narrowing Scapulo - Humeral joint in 100%. Postoperative complication with dimpling of the skin or staircase like deformity and loss of the natural roundness of the lateral aspect of the shoulder in 33.5%. Conclusions: Pathological anatomy of fibrous deltoid muscle related surgical technique and postoperative complications. The big breadth and diameter of fibrous portion could create a dimpling of the skin or loss of the natural roundness of the lateral aspect of the shoulder.