Shoulder and Elbow Surgery Service, Hautepierre 2, CHRU Strasbourg, av. Molière, 6785, Strasbourg, France.
, Strasbourg, France.
Int Orthop. 2020 May;44(5):905-910. doi: 10.1007/s00264-020-04540-x. Epub 2020 Mar 28.
The primary objective of this retrospective study was to validate electrophysiological results of latissimus dorsi tendon transfer (LDTT) to determine if this transfer is active for different daily living tasks, and the secondary objective was to correlate these clinical results.
With a mean follow-up of 4.7 years, 14 latissimus dorsi tendon transfers were retrospectively reviewed. Patients were clinically evaluated with the constant score and the SSV. Healing of the tendon on the greater tuberosity and atrophy of the LDTT muscle was determined by ultrasound and compared with the contralateral side. Electrical activity was analyzed by electromyography in active elevation, abduction, and external rotation.
Twelve patients are satisfied (SSV). At the last follow-up, the EMG found a significant electrical activity in the abduction and external rotation and a lower activity in adduction and internal rotation. The mean constant score increased from 29 to 51, the mean forward elevation increased from 89° to 135°, the mean abduction from 92° to 105°, and the external rotation from 12° to 24°. The ultrasound found 12 healed tendons and two ruptures at the myotendinous junction.
Electrical activity in abduction and external rotation testifies that the LDT transfer acts as an active muscle transfer and acts not only a muscle tenodesis that covers the humeral head.
本回顾性研究的主要目的是验证背阔肌肌腱转移（LDTT）的电生理结果，以确定该转移在不同日常活动任务中的活性，次要目的是对这些临床结果进行相关性分析。
在平均 4.7 年的随访中，回顾性分析了 14 例背阔肌肌腱转移患者。采用Constant 评分和肩肘外科协会（SSV）评分对患者进行临床评估。通过超声检查确定冈上肌腱在大结节上的愈合情况和 LDTT 肌肉的萎缩情况，并与对侧进行比较。通过肌电图分析主动抬高、外展和外旋时的电活动。
12 例患者（SSV）满意。在最后一次随访时，肌电图发现外展和外旋时有明显的电活动，而内收和内旋时的电活动较低。Constant 评分从 29 分增加到 51 分，前向抬高的平均角度从 89°增加到 135°，外展的平均角度从 92°增加到 105°，外旋的平均角度从 12°增加到 24°。超声检查发现 12 根肌腱愈合，2 根肌腱在肌腹肌腱连接处断裂。
外展和外旋测试中的电活动证明，LDTT 转移作为一种主动肌肉转移，不仅起到覆盖肱骨头的肌腱固定作用。
