Abstract
Introduction: Large chronic tears of the supra and infraspinatus tendons lead to pain and dysfunction of the shoulder. If conservative treatment fails and repair is impossible, transfer of the latissimus dorsi (LD) muscle can be attempted to substitute for lost of supero-posterior cuff function.
Method: In 2003 nad 2004, twenty five patients with an average age of 54,8 years (range, 51 to 62 years) who had ongoing pain and impaired function underwent the LD transfer after ultrasonographic examination and diagnostic arthroscopy as a primary surgery. The patients were examined at an average of fourteen months (range, twelve to twenty six months) after the operation. The results were assessed with use of Constant-Murley score pre–and postoperatively.
Results: The mean Constant-Murley score increased from 32,50 points preoperatively to 78,75 points postoperatively. The mean score for pain improved of 8,75 points (from 3,75 to 12,50), activities of daily living improved of 10,00 points (from 6,00 to 16,00), range of motion of 15,00 points (from 14,00 to 29,00) and strengh improved of 11,50 points (from 8,75 to 21,25). 20 patients (80%) were very satisfied and 5 patients (20%) were satisfied. The postoperative pain relief was left as the predominant improvement. No patient was disappointed. All patients stated that they would have the operative procedure again under similar circumstances. There was only one complication – subcutaneous haematoma treated with revision and drainage.
Conclusions: Our results indicate that LD transfer is a reasonable approach for salvage of a massive tear of the supero-posterior rotator cuff. Despite the difficult operation technique and long rehabilitation phase, this procedure improves the subjective and objective findings.
Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Email: office@efort.org
