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24.08.2020 | Surgical Management of Massive Irreparable Cuff Tears (J Sanchez-Sotelo, Section Editor) | Ausgabe 6/2020

Current Reviews in Musculoskeletal Medicine 6/2020

Pectoralis Major and Anterior Latissimus Dorsi Transfer for Subscapularis Tears

Zeitschrift:
Current Reviews in Musculoskeletal Medicine > Ausgabe 6/2020
Autoren:
Marion Burnier, Thibault Lafosse
Wichtige Hinweise
Marion Burnier and Thibault Lafosse equally contributed to the redaction of this Manuscript
This article is part of the Topical Collection on Surgical Management of Massive Irreparable Cuff Tears.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Purpose of Review

Irreparable subscapularis tears represent a challenging entity, especially when they occur in younger patients with high functional demands. Tendon transfers are one of the options considered for surgical management for this pathology. The purpose of this article is to review the surgical technique and outcome of the two most common tendon transfers considered for irreparable subscapularis tears: pectoralis major and latissimus dorsi.

Recent Findings

Transfer of the pectoralis major has been considered for decades the transfer of choice for irreparable subscapularis tears. Recently, a series with long-term follow-up (over 18 years) supported the reduction in pain and improvement in functional scores and patient satisfaction after pectoralis major transfer. However, the range of motion and the force in internal rotation were not maintained over time. Transfer of the latissimus dorsi to the lesser tuberosity has been recently described as an alternative with a sound biomechanical rationale and encouraging short-term results.

Summary

Transfer of the pectoralis major and the transfer of latissimus dorsi to the lesser tuberosity are the two transfers most commonly considered for patients with irreparable subscapularis tears. Transfer of the pectoralis major has a much longer track record. Both procedures seem to improve outcomes. Comparative studies are needed to determine the relative indications of these two procedures.

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