| 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. |
Massive cuff tears treated with arthroscopically assisted latissimus dorsi transfer. Surgical technique
De Cupis V., De Cupis M.
Original Article, 149 - 153
Keywords: arthroscopy, latissimus dorsi, posterosuperior cuff tear, shoulder, tendon transfer,
Table of Content: Vol. 2 (No. 2) 2012 April/June
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Treatment of adhesive capsulitis: a review
D'Orsi G.M., Giai Via A., Frizziero A., Oliva F.Review Article, 70 - 78 -
The force-length relationship of the cat soleus muscle
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Pectoralis major tendon rupture. Surgical procedures review.
Merolla G., Paladini P., Campi F., Porcellini G.Review Article, 96 - 103 -
Shock wave over hand muscles: a neurophysiological study on peripheral conduction nerves in normal subjects
Manganotti P., Amelio E., Guerra C.Original Article, 104 - 107 -
The morphology and symptom history of the Achilles tendons of figure skaters: an observational study
Perry M., Tillett E., Mitchell S., Maffulli N., Morrissey D.Original Article, 108 - 114 -
Neuromuscular efficiency of the vastus medialis obliquus and postural balance in professional soccerathletes after anterior cruciate ligament reconstruction
Chaves S.F., Marques N.P., Lemos e Silva R., Rebouças N.S., de Freitas L.M., de Paula Lima P.O., de Oliveira R.ROriginal Article, 121 - 126 -
Leg extension test, semg and vibratory stimuli to assess functional recovery following knee joint surgery
Foti C., Laurini A., Tiberti S., Carli G., Tsarpela O., Adamidis K., Bonifazi M., Giombini A., Tihanyi J., von Duvillard S., De Vita M., BoscoOriginal Article, 127 - 132 -
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Biz C., Vinanti GB., Rossato A., Arnaldi E., Aldegheri R.Original Article, 133 - 136 -
Insertional tendinopathy of the adductors and rectus abdominis in athletes: a review
Valent A., Frizziero A., Bressan S., Zanella E., Giannotti E., Masiero S.Review Article, 142 - 148 -
Massive cuff tears treated with arthroscopically assisted latissimus dorsi transfer. Surgical technique
De Cupis V., De Cupis M.Original Article, 149 - 153