To evaluate the clinical and functional results of surgical treatment for fibrous deltoid muscle in children, a retrospective study has been undertaken. The data were analysed on 105 patients with age over 5 years (182 shoulders) from August 1994 to December 2004. Surgical techniques performed by the author were divided into four types: (i) type I, proximal release of intermediate portion of deltoid muscle; (ii) type II, distal release of intermediate portion of deltoid muscle; (iii) type III, lengthening of intermediate portion of deltoid muscle; and (iv) type IV, distal release of intermediate portion of deltoid muscle and transfer of posterior portion of deltoid muscle to fill the gap. Accordingly, clinical and functional results were compared among four groups. The average duration of follow-up was 3 years and 2 months (range, 2-9 years and 5 months). Overall, in 174 shoulders (95.6%, 99 patients), we had a good clinical result; in two shoulders (1.1%, two patients) a fair result; and poor result in only six shoulders (3.3%, four patients). Postoperative formation of stairstep deformity or loss of roundness of the lateral aspect of shoulder in type I: 46.2%; type II: 30.3%; type III: 16.7%; type IV: 4.3%. Generally, surgical treatment gave good results. Technique type IV had reduced rate of stairstep deformity or loss of the natural roundness of the lateral aspect of the shoulder muscle. Sixty-eight patients (98.6%) in this group achieved a satisfactory outcome.
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Background: Quadrilateral space syndrome is a painful disorder of the shoulder caused by static or dynamic entrapment of the axillary nerve and the posterior humeral circumflex artery. It was first described in 1983; however, it is an uncommon syndrome that initially presents with nonspecific shoulder pain or selective deltoid atrophy, and diagnosis is often delayed owing to its rarity. Young athletes of overhead sports are more commonly affected by this syndrome.
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