Clark Nicholas J, Elhassan Bassem T
Department of Orthopedic Surgery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
Curr Rev Musculoskelet Med. 2018 Mar;11(1):141-149. doi: 10.1007/s12178-018-9468-1.
This review aims to describe the tendon transfer options for treating irreparable rotator cuff tears (RCTs). Options for transfer include latissimus dorsi and lower trapezius transfers for posterior-superior RCTs and pectoralis major and latissimus dorsi transfer for anterior-superior RCTs.
While the latissimus dorsi tendon transfer has historically been performed for posterosuperior RCTs, the lower trapezius transfer is a more anatomic option and has demonstrated promising results in recent studies. Similarly, the pectoralis major transfer has historically been the tendon transfer of choice for anterosuperior RCTs. However, the latissimus dorsi tendon transfer has recently been shown to be a safe and anatomic tendon transfer for subscapularis insufficiency. The treatment of irreparable RCTs involves complex decision making. Tendon transfer procedures can restore the glenohumeral joint force couples, allowing restoration of near-normal shoulder kinematics. Benefits include reliable pain relief, increased function, and increased strength. Proper selection of donor tendon is crucial, and the principles of tendon transfer procedures must be adhered to for maximal benefit.
本综述旨在描述治疗不可修复性肩袖撕裂（RCT）的肌腱转移选择。转移选择包括用于后上型RCT的背阔肌和下斜方肌转移，以及用于前上型RCT的胸大肌和背阔肌转移。
虽然背阔肌腱转移历来用于后上型RCT，但下斜方肌转移是一种更符合解剖学的选择，并且在最近的研究中已显示出有前景的结果。同样，胸大肌转移历来是前上型RCT的首选肌腱转移方式。然而，背阔肌腱转移最近已被证明是治疗肩胛下肌功能不全的一种安全且符合解剖学的肌腱转移方法。治疗不可修复性RCT涉及复杂的决策。肌腱转移手术可以恢复盂肱关节力偶，从而恢复接近正常的肩部运动学。益处包括可靠的疼痛缓解、功能增强和力量增加。正确选择供体肌腱至关重要，必须遵循肌腱转移手术的原则以获得最大益处。
