Alrabaa Rami George, Ahmad Christopher S
Department of Orthopedic Surgery, Columbia University Medical Center, New York, New York, U.S.A.
Arthrosc Tech. 2020 Jan 24;9(2):e267-e273. doi: 10.1016/j.eats.2019.10.006. eCollection 2020 Feb.
Latissimus dorsi tendon ruptures are less-common injuries that can occur in elite throwing athletes. Physical examination of the thrower with a latissimus injury may show ecchymosis of the upper arm and asymmetry of the posterior axillary fold along with possible weakness in shoulder adduction, extension, and internal rotation. Magnetic resonance imaging is used to confirm the diagnosis. Latissimus tendon ruptures are largely treated nonoperatively; surgical repair is only advocated for in professional throwing athletes with complete avulsion injuries or midsubstance latissimus tendon tears. Surgical repair options include the use of suture anchors, cortical suture buttons, or transosseous sutures via a single posterior axillary incision or a 2-incision technique. Given the limited literature on this topic, there have been no studies evaluating the different fixation options or surgical approaches for tendon repair. This article and accompanying video show the technique and discusses the technical pearls of a latissimus tendon repair using suture button fixation via a single-incision approach.
背阔肌腱断裂是精英投掷运动员中较少见的损伤。对背阔肌受伤的投掷运动员进行体格检查时，可能会发现上臂瘀斑、腋窝后皱襞不对称，同时肩内收、伸展和内旋可能无力。磁共振成像用于确诊。背阔肌腱断裂大多采用非手术治疗；仅提倡对有完全撕脱伤或背阔肌腱实质中部撕裂的职业投掷运动员进行手术修复。手术修复方法包括通过单一腋窝后切口或双切口技术使用缝合锚钉、皮质缝合纽扣或经骨缝合线。鉴于关于该主题的文献有限，尚无研究评估肌腱修复的不同固定方法或手术入路。本文及随附视频展示了该技术，并讨论了采用单切口方法使用缝合纽扣固定进行背阔肌腱修复的技术要点。
