Total acromionectomy. A twenty-year review.

Thirty-five patients (thirty-eight shoulders) were treated consecutively with a total acromionectomy between 1969 and 1989. At a minimum of two years (average, five years and eight months) after the operation, thirty-one patients (thirty-four shoulders) were available for review. The results, which were rated on the basis of pain, function, range of motion, strength, and the satisfaction of the patient, were excellent for twenty-five shoulders, good for four, fair for three, and poor for one. Four of the five least satisfactory results were in patients who had had a long-standing massive tear of the rotator cuff. This study was done to separate the criticism of the operative procedure of total acromionectomy from an avoidable complication of that procedure, retraction of the deltoid, and to describe the specific advantages and satisfactory results that occur when that complication is avoided. It is my opinion that failure to repair the deltoid adequately results in retraction of that muscle, and that this avoidable complication is responsible for the unfavorable reputation of total acromionectomy.