Latissimus dorsi transfer for treatment of irreparable rotator cuff tears.
Massive rotator cuff tendon ruptures are not uncommon in older patients. We propose the transfer of the latissimus dorsi muscle for treatment of irreparable ruptures associated with functional impairment and chronic pain. Five women and 11 men were so treated and reviewed with an average follow-up of 26 months. The mean age was 60 years. Four patients also had subscapularis deficiency. Results were assessed with the Constant score and the Oxford shoulder score. Humeral head position was analysed. Statistical analysis was performed by the Wilcoxon non-parametrical test. The Constant score increased by 24.2% (p = 0.001) with all parameters showing improvement. Nine patients showed improved humeral head positioning in internal rotation. Three of four patients with a deficient subscapularis had unfavourable results. Latissimus dorsi transfer for the treatment of irreparable massive rotator cuff tears leads to a substantial clinical improvement. An intact subscapularis tendon is mandatory.
Department of Orthopedic Surgery and Traumatology, Onze Lieve Vrouwe Gasthuis Hospital, Amsterdam, The Netherlands.
Alexander A
AA
Weening
W Jaap
WJ
Willems
D000203:Activities of Daily Living; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D053580:Muscle Strength; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D017006:Rotator Cuff / Q000503:physiopathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D020069:Shoulder Pain / Q000503:physiopathology / Q000601:surgery; D011795:Surveys and Questionnaires; D013709:Tendon Transfer / Q000379:methods*