Anatomical studies of the deltoid muscle were performed on 16 cadaver
shoulders. The anatomy of the axillary nerve, the vascular pedicles, a
nd the musculocutaneous perforators was assessed. These studies confir
med that part of the deltoid muscle can be used as a vascularised flap
to cover defects of the shoulder while leaving some viable functionin
g muscle intact. We report the use of hemideltoid flaps to treat chron
ic radionecrotic ulcers involving the shoulders of two patients. In th
e first, the posterior part of the muscle was used as a local muscle f
lap. In the second, the anterior part of the muscle was raised with ov
erlying skin to form a musculocutaneous flap. The flaps remained heale
d at one year follow-up. These soft tissue radionecrotic defects over
the shoulder are an uncommon late complication of radiotherapy for bre
ast cancer. Pedicled or free flaps are now recognised as the preferred
methods of treatment.