Massive cuff tears treated with arthroscopically assisted latissimus dorsi transfer. Surgical technique

De Cupis, Vincenzo and De Cupis, Mauro (2012) Massive cuff tears treated with arthroscopically assisted latissimus dorsi transfer. Surgical technique. M.L.T.J. Muscles, Ligaments and Tendons Journal, 2 (2). pp. 149-153. ISSN 2240-4554

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Abstract

Latissimus dorsi transfer is our preferred treatment for active disabled patients with a posterosuperior massive cuff tear. We present an arthroscopically assisted technique which avoids an incision through the deltoid obtaining a better and faster clinical outcome. The patient is placed in lateral decubitus. After the arthroscopic evaluation of the lesion through a posterior and a posterolateral portal, with the limb in traction we perform the preparation of the greater tuberosity of the humerus. We place the arm in abduction and internal rotation and we proceed to the harvest of the latissimus dorsi and the tendon preparation by stitching the two sides using very resistant sutures. After restoring limb traction, under arthroscopic visualization, we pass a curved grasper through the posterolateral portal by going to the armpit in the space between the teres minor and the posterior deltoid. Once the grasper has exited the access at the level of the axilla we fix two drainage transparent tubes, each with a wire inside, and, withdrawing it back, we shuttle the two tubes in the subacromial space. After tensioning the suture wires from the anterior portals these are assembled in a knotless anchor of 5.5 mm that we place in the prepared site on the greater tuberosity of the humerus. A shoulder brace at 15° of abduction and neutral rotation protect the patient for the first month post-surgery but physical therapy can immediately start

Item Type:	Article
Uncontrolled Keywords:	Shoulder, posterosuperior cuff tear, tendon transfer, latissimus dorsi, arthroscopy
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale) > 616.7 Malattie del sistema muscoloscheletrico
Depositing User:	Danilo Dezzi
Date Deposited:	16 Apr 2014 16:07
Last Modified:	16 Apr 2014 16:07
URI:	http://eprints.bice.rm.cnr.it/id/eprint/8126

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