Lin Lin, Liu Qiang, Zhao Fengyuan, Wang Dingyu, Yan Hui
Institute of Sports Medicine Peking University Third Hospital Beijing China.
J Exp Orthop. 2025 Aug 5;12(3):e70391. doi: 10.1002/jeo2.70391. eCollection 2025 Jul.
Tendon transfer of the pectoralis major (PM), pectoralis minor (Pm), latissimus dorsi (LD) and teras major (TM) is recommended for irreparable subscapularis (SSC) tears. This study aimed to describe the landmarks and neurovascular structures in the regions of the four muscles to facilitate their transfer to irreparable SSC tears.
Descriptive laboratory study.
Twelve fresh-frozen adult specimens were dissected and important neurovascular structures around the four tendons were identified. The relationships between the tendons and neurovascular structures were quantitatively investigated during tendon transfer procedures.
The average distance of medial pectoralis nerve (MPN) to the insertion of Pm on the coracoid was 6.5 cm (5.4-8.1 cm). The MPN travelled with the lateral thoracic artery (LTA) to pierce the PM with an average of 9.7 cm (8.3-12.1 cm) medial to the humeral insertion. Axillary nerve and posterior humeral circumflex vessels were above the superior margin of TM muscle with average of 0.8 cm (0.5-1.2 cm). These neurovascular structures crossed posterior to the plane of the LD and TM at 2.6 cm (1.9-3.3 cm) from the humeral insertion of these two muscles. The radial nerve (RN) and its motor branch to triceps were found to lie an average of 2.7 cm (2.0-4.3 cm) medial to the humerus at the superior border of the LD, and an average of 2.4 cm (1.8-3.5 cm) medial to the humerus at the inferior border of the TM. The neurovascular pedicles to the LD and TM were at an average of 12.7 cm (10.2-15.6 cm) and 7.0 cm (5.6-8.5 cm) to the humeral insertions, respectively.
Our results clarify the complex local anatomic structures of the PM, Pm, LD and TM for tendon transfer to treat irreparable SSC tears and provide potentially useful references for tendon transfer.
Not applicable.
对于不可修复的肩胛下肌（SSC）撕裂，推荐进行胸大肌（PM）、胸小肌（Pm）、背阔肌（LD）和大圆肌（TM）的肌腱转移。本研究旨在描述这四块肌肉区域的标志点和神经血管结构，以促进它们转移至不可修复的SSC撕裂处。
描述性实验室研究。
解剖12个新鲜冷冻的成人标本，识别四条肌腱周围重要的神经血管结构。在肌腱转移过程中对肌腱与神经血管结构之间的关系进行定量研究。
胸内侧神经（MPN）至Pm在喙突附着点的平均距离为6.5厘米（5.4 - 8.1厘米）。MPN与胸外侧动脉（LTA）伴行，在肱骨附着点内侧平均9.7厘米（8.3 - 12.1厘米）处穿入PM。腋神经和旋肱后血管位于TM肌肉上缘上方，平均距离为0.8厘米（0.5 - 1.2厘米）。这些神经血管结构在距这两块肌肉肱骨附着点2.6厘米（1.9 - 3.3厘米）处，于LD和TM平面后方交叉。桡神经（RN）及其至肱三头肌的运动支在LD上缘处位于肱骨内侧平均2.7厘米（2.0 - 4.3厘米）处，在TM下缘处位于肱骨内侧平均2.4厘米（1.8 - 3.5厘米）处。至LD和TM的神经血管蒂分别距肱骨附着点平均12.7厘米（10.2 - 15.6厘米）和7.0厘米（5.6 - 8.5厘米）。
我们的结果阐明了用于肌腱转移以治疗不可修复的SSC撕裂的PM、Pm、LD和TM的复杂局部解剖结构，并为肌腱转移提供了潜在有用的参考。
不适用。
