Department of Orthopedic Surgery and Traumatology, Onze Lieve Vrouwe Gasthuis Hospital, Amsterdam, The Netherlands.
Int Orthop. 2010 Dec;34(8):1239-44. doi: 10.1007/s00264-010-0970-3. Epub 2010 Feb 16.
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.
肩袖大面积撕裂在老年患者中并不少见。我们建议采用背阔肌转位术治疗伴有功能障碍和慢性疼痛的不可修复性撕裂。5 名女性和 11 名男性接受了这种治疗，并进行了平均 26 个月的随访。平均年龄为 60 岁。4 名患者还存在肩胛下肌缺损。使用 Constant 评分和牛津肩评分进行评估。分析了肱骨头位置。采用 Wilcoxon 非参数检验进行统计学分析。Constant 评分增加了 24.2%（p = 0.001），所有参数均显示改善。9 名患者在内部旋转时肱骨头位置得到改善。4 名肩胛下肌缺损患者中有 3 名结果不佳。背阔肌转位术治疗不可修复的巨大肩袖撕裂可显著改善临床效果。肩胛下肌腱完整是必要的。
