Reid Jared J, Garrigues Grant E, Friedman Richard J, Eichinger Joseph K
Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston SC 29412, Clinical Science Building MSC, Code 708, Charleston, SC, USA.
Rush University, Chicago, IL, USA.
Curr Rev Musculoskelet Med. 2024 Mar;17(3):68-75. doi: 10.1007/s12178-023-09881-9. Epub 2024 Jan 6.
Irreparable subscapularis tears, especially in younger patients with higher functional demands, present a challenging entity. Pectoralis major and latissimus dorsi tendon transfers are commonly considered for surgical management of this pathology, yet no consensus exists regarding the superior option. The purpose of this article is to review the most current tendon transfer techniques for irreparable subscapularis tears.
For decades, transfer of the pectoralis major has been considered the gold standard technique for irreparable subscapularis tears. This transfer was found to reduce pain and improve functional outcome scores, yet range of motion and force of internal rotation were not maintained in long-term follow-up studies. The latissimus dorsi tendon transfer for the same indications has demonstrated biomechanical superiority in recent cadaveric studies with promising short-term results clinically. Both pectoralis major and latissimus dorsi tendon transfers improve outcomes of patients with irreparable subscapularis tears. Future comparative studies are still needed to determine superiority amongst techniques.
不可修复的肩胛下肌撕裂，尤其是在功能需求较高的年轻患者中，是一个具有挑战性的问题。胸大肌和背阔肌肌腱转移术通常被用于该疾病的手术治疗，但对于哪种方法更优尚无共识。本文旨在综述目前治疗不可修复肩胛下肌撕裂的最新肌腱转移技术。
几十年来，胸大肌转移术一直被认为是治疗不可修复肩胛下肌撕裂的金标准技术。该转移术可减轻疼痛并改善功能结局评分，但长期随访研究发现其无法维持活动范围和内旋力量。近期尸体研究表明，相同适应症下的背阔肌肌腱转移术在生物力学上具有优势，临床短期结果也很有前景。胸大肌和背阔肌肌腱转移术均能改善不可修复肩胛下肌撕裂患者的预后。未来仍需要进行比较研究以确定不同技术之间的优势。
