Belk John W, Bravman Jonathan T, Frank Rachel M, Seidl Adam J, McCarty Eric C
Department of Orthopedics, University of Colorado School of Medicine, University of Colorado, Aurora, Colorado, USA.
Video J Sports Med. 2022 Dec 27;2(6):26350254221128040. doi: 10.1177/26350254221128040. eCollection 2022 Nov-Dec.
Latissimus dorsi tendon ruptures are rare injuries that can occur in overhead or throwing motions and are almost always sports related.
Latissimus dorsi tendon ruptures are largely treated nonoperatively, although surgical repair is indicated for the young active patient looking to return to a high level of sport and for those with complete avulsion injuries or mid-substance tendon tears.
Depending on the degree of tendon retraction, anteroinferior or posteroinferior axillary incision is made. After the tendon is mobilized, sutures are placed in a Krackow fashion through the bulk of the tendon, and the tendon footprint is prepared by gently decorticating the surface of the humerus, just anterior and inferior to the teres major insertion point. Two Arthrex Pec Buttons are then loaded into the superior and inferior limbs of the suture tape and 2 unicortical holes are drilled into the footprint of the insertion site. The superior button is placed first and then tensioned to allow the latissimus dorsi to be pulled to the bone. Next, the second button is placed, though this is not tensioned until later at the time of the biceps tenodesis. Finally, the procedure is visualized and well inspected to ensure appropriate location of the tendon and securing hardware.
After an appropriate rehabilitation protocol is followed for up to 6 months postoperatively, acute repair of a ruptured latissimus dorsi tendon allows for near to complete restoration of patient functionality and strength, with return to full activity possible within 6 to 8 months.
Surgical repair of a ruptured latissimus dorsi tendon is effective in restoring upper extremity strength and functionality and is associated with high patient satisfaction.The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
背阔肌腱断裂是一种罕见的损伤，可发生于过顶或投掷动作中，几乎均与运动相关。
背阔肌腱断裂大多采用非手术治疗，不过对于期望恢复高水平运动的年轻活跃患者以及那些有完全撕脱伤或肌腱实质中部撕裂的患者，建议进行手术修复。
根据肌腱回缩程度，做腋前下或腋后下切口。肌腱游离后，以Krackow缝合法在肌腱主体穿过缝线，通过轻轻打磨肱骨表面（就在大圆肌止点前方和下方）来准备肌腱附着点。然后将两个Arthrex Pec纽扣装入缝线带的上下肢，并在附着点足迹处钻两个单皮质孔。先放置上方纽扣并拉紧，以使背阔肌拉至骨面。接着放置第二个纽扣，不过直到稍后进行二头肌腱固定时才拉紧。最后，观察并仔细检查手术过程，以确保肌腱和固定硬件位置合适。
术后遵循适当的康复方案长达6个月，背阔肌腱断裂的急性修复可使患者功能和力量近乎完全恢复，6至8个月内有可能恢复完全活动。
背阔肌腱断裂的手术修复在恢复上肢力量和功能方面有效，且患者满意度高。作者证明已获得本出版物中出现的任何患者的同意。如果个体可识别，作者已随本投稿附上患者的豁免声明或其他书面批准形式以供发表。
