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Master, Specialist Doctor I Nguyen Thi Thanh Binh - Rehabilitation Doctor - General Surgery Department - Vinmec Danang International Hospital
Delta muscle fibrosis is a medical condition in which the muscle fibers in the Delta muscle are transformed into fibrous bands, causing contraction of the Delta muscle and causing secondary deformities, changing the appearance of the shoulder, affecting the function of the Delta muscle. shoulder function and body aesthetics. They make many people think this is a disability and cannot be treated. In fact, rehabilitation of Delta fibromyalgia is not too difficult, so patients should be intervened early when secondary deformities have not appeared.
1. Delta muscle fibrosis
Delta fibromyalgia is a disease that affects the mobility of the shoulder joint. Its characteristic makes it impossible for the patient to bring the arm into contact with the chest at the anatomical position of the shoulder blade. The disease can be congenital or acquired. Cases of Delta muscle fibrosis may be due to the patient's history of multiple intramuscular injections into the Delta muscle.Delta muscle fibrosis has a gradual progression, muscle cells gradually turn into fibroblasts due to physico-chemical factors such as trauma (muscle constriction), local bleeding, edema (not nourishing the tissues). muscle organization) or by chemical agents that change the nutrients as well as the metabolism of muscle cells. The result of this condition will be loss of elasticity of the muscle, causing contraction and loss of motor function of the muscle.
Delta muscle fibrosis can easily be misdiagnosed as anterior shoulder dislocation, anterior neck paralysis. Therefore, an accurate diagnosis of fibromyalgia will help to correct it more effectively, especially in the early stages.
Xơ hóa cơ Delta làm mất khả năng vận động của khớp vai
2. Diagnosis of disease
2.1. Implementing the quadrants
Examination of medical history: Injury, infection of shoulder joint, antibiotic or vaccine injection, time of appearance of deformity.Evaluation of clinical function: To perform this process, the doctor will rely on the most prominent and recognizable signs of Delta muscle fibrosis through assessment of joint movement, palpation of the shoulder joint...
Observe the shoulder joint: First, we will observe from the front the sacral processes (shoulders are lowered, the upper ends of the bones are protruding first). Next, we will observe the forearms and elbows indents on the skin surface, grooves. concave along the muscle body (medial bundle of the Delta muscle)
Observation from the back: lateral scapula are pulled low with fibrosis, the medial margin of the scapula is detached from the posterior thoracic wall, the lower pole of the scapula can be rotated outward. In addition, the spines behind the shoulder blades are prominent.
The patient cannot bring the arm close to the torso when at rest, the elbows are difficult or impossible to touch when bringing the arm forward in the flexed elbow position. The shoulder blades are raised and rotated in the shape of a bird's wings.
Mobilize the shoulder joint. The brachial-brachial angle is the critical angle to evaluate the fibromyalgia of the Delta. If this angle is greater than 25 degrees, it will be one of the decisive indicators of surgical treatment.
Move shoulder-width apart. The degree of delta muscle fibrosis can limit adduct motion in the scapula below 90 degrees and even below 45 degrees.
Shoulder joint movement. The disease can limit shoulder joint movement to less than 90 degrees, even the spine may tilt to the same side.
Based on the preliminary examination results, the doctor can give some indications for tests such as: Ultrasound (Can see the fibrous strip of the Delta muscle, the size is less than 1cm in diameter and about 6-8cm in length. ); X-ray . Observe the image of shoulder dislocation; Electromyography )This test will determine if there is damage to the peripheral nerves that control muscle movement); Muscle enzymes (measurement of Creatinine Phosphokinase to determine if there is a state of destruction of muscle cells); histopathology (assessment of muscle degeneration or invasion of fibroblasts replacing muscle cells)
Thực hiện vận động khép khớp vai để đánh giá tình trạng bệnh
Chẩn đoán xác định xơ hóa cơ Delta bằng hình ảnh
2.2. Differential diagnosis
Some diseases related to neuromuscular and shoulder joint need to be differential diagnosis such as: Duchenne muscular dystrophy, spinal muscular dystrophy, congenital polyarthritis, brachial plexus palsy.3. Principles of rehabilitation of fibromyalgia Delta
Delta fibromyalgia rehabilitation treatment is based on increased mobility of the shoulder and elbow joints. At the same time, against fibrosis and muscle atrophy in the shoulder joint.Some commonly used methods and techniques for the recovery of fibromyalgia Delta:
Infrared physiotherapy: high frequency electricity and ultrasound. This method is applied 72 hours after Delta muscle surgery and this is the preparation phase before entering the training process. Mobility exercises: Doctors will base on the specific situation of each patient to prescribe exercise exercises to restore function of fibromyalgia. The patient will be instructed by the technicians to perform exercises such as: shoulder-hand joint exercise, humeral head rotation, external arm rotation, exercise combined with external flexion and external rotation, shoulder cross training, exercise training. external rotation of the arm, combined movement of flexion and external rotation, movement of the arm in a sitting position. After rehabilitation of Delta fibromyalgia, patients are still monitored and re-examined after 3 months, 6 months, 12 months and 36 months to ensure that there will be no recurrence of fibromyalgia conditions, limiting movement or joint deformity.
Vinmec International General Hospital is not only famous as an address for examination, treatment and prevention of many diseases, but also famous for its excellent medical services, standard hospital space, and full facilities. All kinds of machines for medical examination and rehabilitation.
Customers who need medical examination and treatment at Vinmec can directly go to Vinmec Health system nationwide for examination or contact the hotline here for support.
Master. Doctor Nguyen Thi Thanh Binh has 30 years of experience in the specialty of Rehabilitation, especially experienced in Rehabilitation of musculoskeletal, neurological, spine diseases of adults and children. Currently, he is a Rehabilitation Doctor at the Department of General Surgery, Vinmec International General Hospital, Da Nang.
Customers who need medical examination and treatment can directly go to Vinmec International General Hospital nationwide or contact the hotline HERE.
