de Cabo Gonzalo, González-Martín David, Martínez de Aragón Alberto, Rubio Juan A, Leyes Manuel
Department of Orthopedic Surgery and Traumatology, Olympia, Quirón Salud, Madrid, Spain.
Department of Orthopedic Surgery and Traumatology, Origen, Grupo Recoletas, Valladolid, Spain.
Arthrosc Tech. 2023 Jun 26;12(7):e1233-e1240. doi: 10.1016/j.eats.2023.03.014. eCollection 2023 Jul.
Massive irreparable cuff tears may represent as many as 20% to 40% of total cases of operated rotator cuff tears and can be a challenging clinical problem. Many treatment options have been proposed for their treatment. Among these options, latissimus dorsi tendon transfer can be considered a good alternative, especially in young patients before they develop glenohumeral arthritic changes. This technique aims at rebalancing the shoulder with a functioning subscapularis muscle and restoring both active external rotation and elevation with the aid of a properly functioning deltoid muscle. The modified arthroscopic latissimus dorsi transfer at the infraspinatus footprint with anterior extracortical fixation rebalances the pair of forces acting on the shoulder, stabilizing it in the transverse plane, minimizing the risk of latissimus dorsi transferred rupture and associated complications.
巨大的不可修复的肩袖撕裂可能占手术治疗的肩袖撕裂病例总数的20%至40%，并且可能是一个具有挑战性的临床问题。针对其治疗已经提出了许多治疗方案。在这些方案中，背阔肌肌腱转移可以被认为是一种很好的选择，尤其是对于尚未出现盂肱关节关节炎改变的年轻患者。该技术旨在通过发挥功能的肩胛下肌重新平衡肩部，并借助正常发挥功能的三角肌恢复主动外旋和抬高功能。在冈下肌足迹处采用前皮质外固定的改良关节镜下背阔肌转移可重新平衡作用于肩部的一对力，在横平面上使其稳定，将背阔肌转移破裂及相关并发症的风险降至最低。
