Simionato Ivan Fadanelli, Matsumoto Fábio Yoshihiro, Britto Almiro Gerszon, Ferreira Marco Tonding, Eichenberg Augusto Heinen, Mothes Fernando Carlos
Grupo de Cirurgia do Ombro, Departamento de Ortopedia e Traumatologia, Santa Casa de Porto Alegre, Porto Alegre, RJ, Brasil.
Departamento de Ortopedia e Traumatologia, Clínica Conex, Ijuí, RS, Brasil.
Rev Bras Ortop (Sao Paulo). 2021 Oct 28;56(5):671-674. doi: 10.1055/s-0041-1726060. eCollection 2021 Oct.
Lesions to the shoulder rotator cuff may have several configurations, and are divided and classified according to the size of the lesion, the tendon involved, its combinations and whether there is possibility of repair. Irreparable subscapular lesions, as well as irreparable anterosuperior lesions, may generate shoulder dysfunction due to loss of humeral head depressants, causing pain and functional limitation. Myotendinous transfers are among the therapeutic alternatives, and the most studied and widespread in recent decades is the transfer of the pectoralis major to the minor tuberosity. However, some anatomical studies suggest that the latissimus dorsi is a more appropriate alternative for the treatment of these lesions because it presents force vectors more similar to those of the subscapularis, besides presenting promising results in the clinical evaluations with short follow-up. The present work aims to describe the surgical technique developed for transfer of the latissimus dorsi in cases of irreparable subscapular and anterossuperior lesions to the rotator cuff.
肩部旋转袖带损伤可能有多种形态，并根据损伤大小、受累肌腱、其组合情况以及是否有可能修复进行分类。不可修复的肩胛下肌损伤以及不可修复的前上方损伤，可能由于肱骨头下压肌的丧失而导致肩部功能障碍，引起疼痛和功能受限。肌腱转移术是治疗选择之一，近几十年来研究最多且应用最广泛的是胸大肌向小结节的转移。然而，一些解剖学研究表明，背阔肌是治疗这些损伤更合适的选择，因为它的力向量与肩胛下肌更相似，而且在短期随访的临床评估中也呈现出有前景的结果。本研究旨在描述在不可修复的肩胛下肌和前上方损伤至旋转袖带的病例中，为背阔肌转移所开发的手术技术。
