Spears Thomas, Luchini Patrick, Nayfa Robert, Chang Peter, LeClere Lance
Orthopaedic Sports Medicine and Shoulder Surgery Fellowship, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Video J Sports Med. 2025 Jan 8;5(1):26350254241291592. doi: 10.1177/26350254241291592. eCollection 2025 Jan-Feb.
This is a rare case of the surgical treatment of a subacute presentation of a latissimus dorsi tendon rupture via a posterior single-incision approach.
The patient had extensive conservative, nonoperative treatment that failed, and ultimately a surgical intervention was required to return to his activities of daily living.
The patient is positioned in a lateral decubitus position. A 10-cm incision is created along the posterior axillary fold. Sharp and blunt dissection is utilized to carefully mobilize the chronic tendon rupture. The tendon is captured with 2 suture tapes utilizing a locking Krackow whipstitch. The tendon footprint is identified between the pectoralis major and teres major. The insertion point is prepared with a Cobb to debride the soft tissue and decorticate the bone bed to optimize healing. Two endobuttons are loaded with the suture tapes and then passed through unicortical holes drilled in the tendon bed. Care is taken to ensure the 90° external rotation of the tendon is achieved. A tendon-slide technique is used to reduce the tendon to the humerus. Afterward, a free needle is used to pass 1 limb of the suture through the tendon before tying an additional knot for added fixation.
The patient was able to resume his activities of daily living without pain at the 4-month mark.
After the failure of extensive nonoperative management, surgical treatment of a subacute complete rupture of the latissimus dorsi tendon via a single, posterior incision is an effective method of returning a patient to their painless activities of daily living.
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.
这是一例通过后正中单切口入路手术治疗背阔肌腱亚急性断裂的罕见病例。
患者接受了广泛的保守非手术治疗但失败，最终需要手术干预以恢复日常生活活动。
患者取侧卧位。沿腋后皱襞做一个10厘米的切口。采用锐性和钝性分离仔细游离慢性肌腱断裂处。用2根缝线带通过锁定Krackow缝合法固定肌腱。在胸大肌和大圆肌之间确定肌腱附着点。用骨膜剥离子清理软组织并对骨床进行皮质剥脱以优化愈合。将两个内纽扣式接骨板装上缝线带，然后穿过在肌腱床钻的单皮质孔。注意确保肌腱达到90°外旋。采用肌腱滑动技术将肌腱复位至肱骨。之后，在打结额外固定结之前，用游离针将缝线的一肢穿过肌腱。
患者在4个月时能够无痛地恢复日常生活活动。
在广泛的非手术治疗失败后，通过单一后正中切口对背阔肌腱亚急性完全断裂进行手术治疗是使患者无痛恢复日常生活活动的有效方法。
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，作者在提交本稿件以供发表时已包含患者的豁免声明或其他书面形式的批准。
