• Clinics in Shoulder and Elbow
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• v.24 no.3
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• pp.178-182
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• 2021

A 50-year-old woman who had been previously diagnosed with systemic lupus erythematosus consulted our clinic for pain and weakness in her right shoulder. On examination, she had an atrophied deltoid muscle, a painful right shoulder on movement, and a tender mass in the deltoid area. The patient was diagnosed with corticosteroid-induced deltoid myopathy, shoulder pain, and loss of range of motion that did not resolve with conservative treatment. We decided to perform reverse shoulder arthroplasty. No complications were observed at the last follow-up visit at 3 years postoperative. Unlike deltoid insufficiency that results from axillary nerve injury, deltoid myopathy due to corticosteroid use contains intact fibers,. Therefore, we increased the effectivity of the remaining deltoid fibers by extending the moment arm of the anterior fibers using reverse shoulder arthroplasty and achieved reliable improvements in clinical symptoms and function without increasing the risk of dislocation.

• Journal of Korean Foot and Ankle Society
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• v.26 no.1
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• pp.16-21
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• 2022

When an ankle lateral malleolar fracture is accompanied by a deltoid ligament rupture without a medial malleolar fracture, such an injury is called a bimalleolar equivalent fracture. This means that even if there is no bony injury on the medial side, there may be functional instability of the ankle joint due to damage to the deltoid ligament. Manual or gravity external rotational stress radiography is used to differentiate an ankle bimalleolar equivalent fracture from an isolated lateral malleolar fracture. If the medial joint gap is widened on the stress radiography, the deltoid ligament injury can be diagnosed, and surgical treatment for fibula fractures is recommended. After open reduction of the fibula fracture (with syndesmotic fixation if needed), a decision on the repair of the deltoid ligament is taken depending on the surgeons' preference and intraoperative findings. The deltoid ligament repair is performed by inserting a suture anchor (or anchors) in the medial malleolus and fixing the deep and superficial deltoid ligaments to the medial malleolus. The only randomized study to evaluate the utility of deltoid ligament sutures in ankle fractures did not support the deltoid ligament suture, but the study itself had many limitations. An appropriately powered, randomized, controlled trial of the deltoid ligament repair with both patient-reported outcome and radiographic outcome evaluation is needed in the future.

• International Journal of Safety
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• v.4 no.1
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• pp.27-31
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• 2005

This study presents the relationship between the height of the chair and the force of deltoid muscle for pianist. The subject simulated playing the piano on the three different heights of the chairs. Digital camera was used to determine the angle of the joint of shoulder and elbow for 2-dimensional static link segment modeling in the sagittal plane. The deltoid, biceps and triceps muscles were considered to determine the muscle load. The results, compared to the force of deltoid muscle, are that the downward position of the higher chair produces significantly large force than the other two lower chairs. It can be caused by hunched shoulder with decreasing deltoid angle. In case of the upward position caused by the lower chair, even though the smallest force of deltoid presented, it was increased the force of elbow.

• Journal of Yeungnam Medical Science
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• v.34 no.1
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• pp.146-148
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• 2017

Concurrent injury of medial malleolus and deltoid ligament is difficult to occur considering the injury mechanism. When the concurrent injury comes about, the deltoid ligament injury could be missed and it may lead to medial ankle instability. There are few reported cases of the concurrent injury and domestic case of concurrent failure of both structures over the medial side has been reported just once; however, the injury mechanism is different from this case. The authors report a case of medial malleolus fracture with deltoid ligament rupture following pronation injury with a review of necessity of repairing deltoid ligament for ankle stability.

• Clinics in Shoulder and Elbow
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• v.25 no.4
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• pp.334-338
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• 2022

Currently, the literature contains few studies that describe any potential complications following arthroscopic acromioplasty. Because part of the anterior deltoid originates from the anterior acromion, there is a risk for violation and subsequent iatrogenic rupture or avulsion during this procedure. This type of injury can be a devastating problem for patients that may lead to poor function and debilitating pain. We present a patient with deltoid insufficiency following arthroscopic acromioplasty who elected to proceed with operative management with a planned arthroscopic evaluation of the shoulder followed by an open deltoid repair. At the final follow-up visit 2.5 years postoperatively, the patient reported improved pain from baseline and no residual disability and was able to perform most activities of daily living without difficulty. This case serves as an example of a surgical repair for a deltoid avulsion following arthroscopic acromioplasty. As there is still a lack of standard guidelines, our suture repair technique can be considered one method of treatment for this type of injury.

• Physical Therapy Korea
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• v.15 no.4
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• pp.34-42
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• 2008

This study aimed to examine whether McConnell taping for deltoid inhibition affects the Electromyographic (EMG) activity of shoulder girdle muscles during arm elevation. Ten young healthy men were randomly assigned to an experimental and control groups of five men each. For the experimental group, we performed taping for deltoid inhibition on the skin over anterior and posterior deltoids with non-elastic specific tape, and sham-taping with non-elastic under-tape for the control group. Surface EMG measurements were performed three times (before, during and after the tapings) at upper and lower trapezius, mid-deltoid, and serratus anterior muscles while elevating dominant aim with loading and unloading conditions. In deltoid inhibition taping group, there were significant differences in EMG activity of mid-deltoid (p<.05) and serratus anterior (p<.05) muscles during arm elevation with loading. During arm elevation without loading, the EMG activity was significantly decreased for MD in the McConnell taping group (p<.05). The findings indicate that deltoid inhibition taping can modify the activation patterns in shoulder girdle muscles as well as in deltoid muscle. in clinical setting. it may be effectively used for the management of patients with shoulder dysfunction.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.71-76
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• 2016

PURPOSE: The purpose of this study was to compare isometric contraction of deltoid middle fiber between elastic band and light dumbbell on various shoulder abduction angle. And this study intends to examine the compare with isometric contraction on deltoid middle fiber in various abduction angle of shoulder joint. METHODS: The participants of this study were Korean healthy adult in their 20s (n=60). The 8 channel surface electromyography was used to measure activity of the deltoid middle fiber at isomeric contraction on various abduction angle: $0^{\circ}$, $30^{\circ}$, $60^{\circ}$, $90^{\circ}$, $120^{\circ}$ of shoulder joint using elastic band: red color Theraband and dumbbell: 2kg. The data used in the analysis of the present study was the root mean square. RESULTS: The deltoid middle fiber activation was not significantly different between elastic band and dumbbell at each abduction angle. The deltoid middle fiber activation significantly increased as more to increased shoulder abduction angle in elastic band and dumbbell. CONCLUSION: The elastic band and dumbbell was to provide the similarly load to the deltoid middle fiber isometric contraction on all of the shoulder abduction angle. The deltoid middle fiber activation increased as more to increased shoulder abduction angle in elastic band and dumbbell. These results may be an important reference in development of exercise on shoulder joint.

• Journal of Korean Foot and Ankle Society
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• v.27 no.2
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• pp.58-66
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• 2023

Purpose: This study aimed to evaluate the effectiveness of deltoid ligament repair on syndesmotic stabilization in patients with acute ankle fractures with ruptured deltoid and syndesmotic ligaments. Materials and Methods: The medical records of 41 patients (41 ankles) who underwent surgery for Weber type B ankle fracture with ruptured deltoid and syndesmotic ligaments were retrospectively analyzed. The mean follow-up duration was 36 months (range 18~65 months). Patients were divided into two groups: those that underwent deltoid ligament repair (the deltoid group) and those who did not (the non-deltoid group). Both groups were also divided into two subgroups, namely, the D1/S1 group, which underwent syndesmotic screw fixation, or the D2/S2 group, which did not. Medial clear space (MCS), tibiofibular clear space (TFCS), anterior fibular line (AFL) ratio, and posterior fibular line (PFL) distance were measured, and visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS), and Foot Function Index (FFI) scores were evaluated. Results: TFCS changed significantly after surgery in the D2 and S1 groups (p=0.01, p=0.03, respectively). Subgroup MCSs, TFCSs, and AFL ratios were not significantly altered by surgery in the four subgroups (p=0.82, p=0.45, p=0.25, respectively). However, postoperative PFL distances were significantly different in the D2 and S1 groups and the S1 and S2 groups (p=0.02, p=0.02, respectively). Mean TFCS decreased significantly after surgery in the D2 and S1 groups. The postoperative VAS, AOFAS scores, and FFI were not significantly different between the subgroups (p=0.44, p=0.40, and p=0.46, respectively). Conclusion: Deltoid ligament repair seemed to restore ankle stability without addressing syndesmosis in Weber type B ankle fractures with rupture of deltoid and syndesmotic ligaments.

• Physical Therapy Korea
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• v.29 no.2
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• pp.106-116
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• 2022

Background: Shoulder external rotation exercises are commonly used to improve the stabilizing ability of the infraspinatus. However, during exercise, excessive activation of the posterior deltoid compared to the infraspinatus causes the humeral head to move anteriorly in an abnormal position. Many researchers have emphasized selective activation of the infraspinatus during shoulder external rotation exercise. Objects: This study aims to delineate the optimal exercise method for selective activation of infraspinatus by investigating the muscle activities of the infraspinatus and posterior deltoid according to the four shoulder exercise methods and two forearm positions. Methods: Thirty healthy individuals participated in this study. The participants were instructed to perform shoulder external rotation exercises following four exercise methods: sitting external rotation (SIER); standing external rotation at 90° abduction (STER); prone external rotation at 90° abduction (PRER); side-lying external rotation (SLER), and two forearm positions (neutral, supinated). The electromyography (EMG) signal amplitude was measured during each exercise. Surface EMG signals were recorded from the posterior deltoid, infraspinatus, and biceps brachii. Results: EMG results of the infraspinatus and posterior deltoid in PRER, were significantly higher than that of the other exercises (p < 0.01). The EMG ratio (infraspinatus/posterior deltoid) in SIER was significantly higher than that of the other exercises. EMG activation of the posterior deltoid in SIER, PRER, and SLER was significantly higher in neutral than in supinated (p < 0.01). Furthermore, the EMG of the infraspinatus in SIER was significantly higher in neutral than in supinated (p < 0.01). The EMG ratio (infraspinatus/ posterior deltoid) in SIER was significantly higher in neutral than in supinated (p < 0.05.) Contrarily EMG ratios in PRER and SLER were significantly higher in supinated than in neutral (p < 0.05). Conclusion: The results show that clinicians should consider these exercise methods and forearm positions when planning shoulder external rotation exercises for optimal shoulder rehabilitation.

• Physical Therapy Korea
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• v.24 no.4
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• pp.77-83
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• 2017

Background: Shoulder external rotation exercises are commonly used to improve the stabilizing ability of the infraspinatus. Although the side-lying wiper exercise (SWE) is the most effective shoulder external rotation exercise to maximize infraspinatus activity, the effect of adduction force on the infraspinatus and posterior deltoid has not been demonstrated. Objects: This study was conducted to investigate whether horizontal adduction force increases infraspinatus activity and decreases posterior deltoid activity. Methods: Twenty-eight healthy subjects (male: 21, female: 7; $age=23.5{\pm}1.8years$; $height=170.1{\pm}7.4cm$; $weight=69.4{\pm}9.6kg$) were recruited. Subjects were asked to perform the SWE under two conditions: (1) general SWE and (2) SWE with adduction force using pressure biofeedback. Surface electromyography (EMG) signals of the infraspinatus and posterior deltoid were recorded during SWE. Paired t-tests were used to compare the EMG activity of the infraspinatus and posterior deltoid between the two conditions. Results: Posterior deltoid muscle activity was significantly decreased following SWE with adduction force ($7.53{\pm}4.52%$) relative to general SWE ($11.68{\pm}8.42%$) (p<.05). However, there was no significant difference in the infraspinatus muscle activity between the SWE with adduction force ($28.33{\pm}12.16%$) and the general SWE ($26.54{\pm}13.69%$) (p>.05). Conclusion: Horizontal adduction force while performing SWE is effective at decreasing posterior deltoid activity.