Gerber C, Vinh T S, Hertel R, Hess C W
Department of Orthopaedic Surgery, University of Berne, Switzerland.
Clin Orthop Relat Res. 1988 Jul(232):51-61.
Symptomatic irrepairable rotator cuff tears usually entail complete loss of the substance of the supraspinatus and infraspinatus tendons. Loss of external rotation control and cranial migration of the humeral head on attempted flexion or abduction of the shoulder are the functional hallmarks. Transfer of the latissimus dorsi tendon from the humeral shaft to the superolateral humeral head provides a large, vascularized tendon that can be used to close a massive cuff defect and that exerts an external rotation and head-depressing moment that allow more effective action of the deltoid muscle. This procedure was carried out in 14 patients without any significant complications. Pain relief and functional results in those four cases with a minimum follow-up period of one year (average, 14 months) compared favorably with alternative treatment methods and warrant further anatomic, electromyographic, and clinical investigation.
有症状的不可修复性肩袖撕裂通常意味着冈上肌和冈下肌腱实质的完全丧失。在试图屈曲或外展肩部时，外旋控制丧失和肱骨头向上移位是其功能特征。将背阔肌腱从肱骨干转移至肱骨头的上外侧，可提供一条粗大、有血供的肌腱，用于闭合巨大的肩袖缺损，并产生外旋和下压肱骨头的力矩，使三角肌的作用更有效。该手术在14例患者中实施，无任何严重并发症。在4例随访至少1年（平均14个月）的患者中，疼痛缓解和功能结果与其他治疗方法相比效果良好，值得进一步进行解剖学、肌电图和临床研究。
