Massive rotator cuff tears treated by a deltoid muscular inlay flap

We reviewed 20 patients with a painful massive, irreparable rotator cuff tear, classified as type III according to Gerber (11). They were all treated with an open partial acromionectomy, an attempt for primary repair and an anterior deltoid muscle inlay flap, as described by Apoil and Augereau. After minimum follow-up of 12 months (average 23.5 months) 17 out of 20 patients were satisfied and better, and the UCLA shoulder scoring (9) improved from an average of 9.35 to an average of 25.7 (max. of 35). Pain and function improved in all patients, with an average of 4.35 and 4.00 points respectively. Active forward flexion improved in 17, and strength of forward flexion improved in 15 patients. Our results were compared with those of Apoil and Augereau, and with the results obtained by other authors after open or closed acromioplasty and cuff tear debridement. This retrospective study tries to give a critical view of this French technique, and concludes that, although no negative effect can be demonstrated by the use of a deltoid muscle flap, a definite advantage cannot be proved.