Gerber C
Department of Orthopaedics, University of Bern, Switzerland.
Clin Orthop Relat Res. 1992 Feb(275):152-60.
Sixteen irreparable, massive rotator cuff tears were treated with latissimus dorsi transfer and reviewed after an average of 33 months. There were no neurovascular complications or infections. Pain relief was satisfactory in 94% of the shoulders at rest and in 81% on exertion. Flexion was 83 degrees preoperatively and 135 degrees postoperatively. The functional value of the shoulder averaged 73% of an age- and gender-adjusted normal score. For the 12 shoulders with a functional subscapularis, it averaged 82%; for those four without a functioning subscapularis, 48%. If the subscapularis was torn and could not be adequately repaired, latissimus dorsi transfer was of no value. In cases with good subscapularis function but irreparable defects in the external rotator tendons, restoration of approximately 80% of normal shoulder function was obtained, indicating that latissimus dorsi transfer is a safe and valuable alternative for the treatment of this specific type of irreparable rotator cuff tear.
16例不可修复的大面积肩袖撕裂采用背阔肌转移术治疗，平均随访33个月后进行评估。未出现神经血管并发症或感染。94%的患肩在休息时疼痛缓解情况令人满意，81%的患肩在用力时疼痛缓解情况令人满意。术前屈曲角度为83度，术后为135度。患肩的功能值平均为年龄和性别调整后的正常评分的73%。对于12例肩胛下肌功能良好的患肩，该值平均为82%；对于4例肩胛下肌功能不佳的患肩，该值为48%。如果肩胛下肌撕裂且无法充分修复，背阔肌转移术则无价值。在肩胛下肌功能良好但外旋肌腱存在不可修复缺损的病例中，可恢复约80%的正常肩功能，这表明背阔肌转移术是治疗这种特定类型不可修复肩袖撕裂的一种安全且有价值的替代方法。
