Deltoid fibrosis - Treatment

Medical therapy involves supervision, stretching exercises, administration of anti-inflammatory drugs and some forms of physical therapy. None of these treatments have proved effective.
Surgical therapy:Surgical therapy of contracture of fibrous bands wanted release.Cases are referred for surgery by the abduction contracture of the rest is above 25 degrees. Patients must have at least 5 years old and present evidence of progressive deformity during growth or changes in the anatomy of bones (humeral head flattening, acromiale morphological changes, enlargement of acromioclavicular joint, scoliosis, thoracic cage collapse). Deltoid contracture at young ages should be corrected surgically when the patient is elderly that allows spontaneous correction of bone deformities with growth. This reduced the risk for late arthritic changes in the incongruity of the humeral head.No significant bone anomalies identified in adults. Deltoidiene tuberosity hypertrophy and cystic lesions of the acromion are reported. The indications for surgical treatment in adults are based on the symptoms of neck or shoulder pain and limitations of daily activities.
A single band contracture is treated by anterior incision. If there are more lanes indicate posterior incision. Posterior incision is used to expose the acromial attachment of the strip. The incision may be transverse or longitudinal. Transverse incision is associated with keloid scar formation. Longitudinal incisions may not allow the whole area deltoidiene exposure and may require multiple incisions to perform the proper release. Proximal incision or resection of the bands can leave significant gaps in the deltoid muscle, causes loss of muscle rotunjimii natural beauty and deformity.
Prognosis:In general the degree of contracture preoperativa not correlate with postoperative results. Whether the shoulder is treated with proximal or distal release, it seems that the complication rate is low and the vast majority of patients gain their movements and shoulder pain. Proximal release may be used if there is only one lane, indicate if there are more distal release. Issue distal stepped avoid deformation associated with the proximal.