Department of Basic Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Department of Anatomy, Center for Basic Sciences, Kasturba Medical College Mangalore, Manipal University, Manipal, India.
J Shoulder Elbow Surg. 2018 Jan;27(1):167-171. doi: 10.1016/j.jse.2017.06.046. Epub 2017 Sep 19.
The latissimus dorsi (LD) is often used for tendon transfers to treat massive irreparable posterosuperior rotator cuff tears. The operation requires the LD tendon to be mobilized to reduce tension on the tendon. In that respect, any connection between the LD tendon and contiguous muscles may hamper tendon mobility and affect the surgical outcome. The goal of this study was to document the occurrence of connections between the LD and adjacent muscles and nerves.
We studied the scapular region on 48 embalmed cadavers. The skin and superficial fascia were removed according to Cunningham's manual of dissection, and the muscle was exposed.
It was found that the LD and teres major (TM) muscles are connected by muscle fibers in 10% of the cadavers studied. Another vital discovery was that in some cadavers, the LD tendon was penetrated by a nerve.
Fascial connections between the LD and TM are well known, but these muscle links are comparatively unusual. From the results of this study, one should pay particular attention to muscle links between the LD and TM during dissection of the LD for transfer. It can also be suggested that during transfer surgery, the LD tendon should be cautiously examined for the possibility of a nerve penetrating it.
背阔肌（LD）常被用于治疗巨大不可修复的肩袖后上侧撕裂的肌腱转移。该手术需要将 LD 肌腱活动以减少肌腱张力。在这方面，LD 肌腱和相邻肌肉之间的任何连接都可能妨碍肌腱活动并影响手术结果。本研究的目的是记录 LD 与相邻肌肉和神经之间的连接情况。
我们研究了 48 具防腐尸体的肩胛骨区域。根据坎宁安解剖手册去除皮肤和浅筋膜，并暴露肌肉。
发现研究的 10%的尸体中，LD 和大圆肌（TM）肌肉之间有肌纤维连接。另一个重要发现是，在一些尸体中，LD 肌腱被神经穿透。
LD 和 TM 之间的筋膜连接是众所周知的，但这些肌肉连接比较罕见。从这项研究的结果来看，在进行 LD 转移时，应该特别注意 LD 和 TM 之间的肌肉连接。也可以建议在转移手术中，应该仔细检查 LD 肌腱是否有神经穿透的可能。
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