Loss of the deltoid after shoulder operations: An operative disaster

A series of 36 patients who had a postoperative loss of the anterior or anterior lateral deltoid muscle after shoulder operations (i.e., acromioplasties, anterior shoulder reconstructions, or arthroplasty procedures) was referred to the senior author. Three patients last the function of their deltoid after an injury to the axillary nerve, and 33 patients lost deltoid function after loss of the origin of the deltoid from the clavicle and acromion. All patients were significantly disabled. All patients were dissatisfied with the result of the previous operation, and eight patients experienced painful anterior or anterior/superior dislocation of the glenohumeral joint. Treatment was nonspecific and supportive. The authors conclude that loss of anterior deltoid function secondary to denervation or detachment results in irrevocable pain and impairment of function. Careful attention to the surgical technique of deltoid reattachment and protection of the axillary nerve are essential to the prevention of dire consequences to shoulder function.