Department of Orthopaedic Surgery, Henri-Mondor Hospital, Paris Public Assistance Hospitals Group, Paris XII Faculty of medicine, 94010 Créteil cedex, France.
Orthop Traumatol Surg Res. 2011 Nov;97(7):719-25. doi: 10.1016/j.otsr.2011.05.012. Epub 2011 Oct 20.
When suture of the torn subscapularis could not be performed, a superior trapezius transfer was used for repair of the tendinous defect. The aim of this article is to report the mid-term functional and radiographic outcome of this technique when complete watertight rotator cuff healings were achieved and to investigate the usefulness of the trapezius transfer. The hypothesis of this work was that the trapezius transfer could not be considered as a useful treatment option.
The study included 20 shoulders demonstrating watertight healing of the rotator cuff on arthro CT-scan control performed 13.5 months after open surgery consisting of a trapezius transfer and suture of all other torn tendons. The mean age at surgery was 58.4 years. The trapezius transfer operative technique is described.
The functional status of the shoulders was assessed preoperatively and at a mean follow-up of 30 months according to the non-weighted Constant score and by measurement of active external rotation, arm at the side. Radiographic and CT-scan assessments were performed preoperatively and at a mean follow-up of 28.5 months. The functional results obtained at last follow-up were compared with those "theoretically estimated" after anatomically successful suture of the torn supra and infraspinatous without associated repair of the torn subscapularis.
Between the pre- and postoperative periods, pain, daily activities and Constant score had all statistically improved. Arthritis was not aggravated but the preoperative anterior subluxation of the humeral head persisted in most cases. The reported Constant scores correlated those "theoretically estimated" in case of non-associated subscapularis repair.
This series is comparable to those evaluating the pectoralis major transfer technique and reports an identical functional outcome.
Since the Constant scores obtained after trapezius transfer correlate those estimated when not combining a subscapularis repair and taking into account the very frequent lack of improvement regarding the preoperative anterior subluxation of the humeral head, the trapezius transfer does not appear as a recommendable treatment option.
当无法进行撕裂的肩胛下肌缝合时，采用了上斜方肌转移来修复肌腱缺损。本文旨在报告在完全水密封的肩袖愈合的情况下，这种技术的中期功能和放射学结果，并研究斜方肌转移的实用性。本研究的假设是，斜方肌转移不能被视为一种有用的治疗选择。
本研究纳入了 20 例在开放手术后通过关节 CT 扫描控制证实肩袖完全水密封的肩关节，手术包括斜方肌转移和所有其他撕裂肌腱的缝合。手术时的平均年龄为 58.4 岁。描述了斜方肌转移的手术技术。
术前和平均随访 30 个月时，根据非加权的 Constant 评分和测量主动外旋、手臂在体侧的情况，评估肩部的功能状态。术前和平均随访 28.5 个月时进行放射学和 CT 扫描评估。最后随访时获得的功能结果与解剖上成功缝合撕裂的上、下肩胛冈肌腱而不伴撕裂的肩胛下肌修复的“理论估计”结果进行比较。
在术前和术后期间，疼痛、日常活动和 Constant 评分均有统计学改善。关节炎没有加重，但术前的肱骨头前脱位在大多数情况下仍然存在。报告的 Constant 评分与未伴肩胛下肌修复的“理论估计”评分相关。
本系列与评估胸大肌转移技术的研究相当，并报告了相同的功能结果。
由于斜方肌转移后获得的 Constant 评分与不合并肩胛下肌修复时的“理论估计”评分相关，并且考虑到术前肱骨头前脱位的改善非常常见，斜方肌转移似乎不是一种推荐的治疗选择。
