MDCT arthrography showed better accuracy than did MR arthrography in the detection of osseous, cartilage, and labroligamentous injuries related to anterior shoulder instability. Because MDCT arthrography was particularly reliable for the detection of glenoid rim fractures and humeral avulsion of the inferior glenohumeral ligament lesions, which represent crucial findings in the preoperative planning, this technique may beneficially affect treatment by means of selecting the proper surgical treatment.

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Musculotendinous transfers (MTT) of latissimus dorsi (LD) and teres major (TM), either in isolation or combination, have recently been advocated to treat irreparable rotator cuff tears. The purpose of this study was to (1) review the anatomy of the LD and TM neurovascular pedicles, and (2) undertake experimental MTT to humeral insertions of either supraspinatus or infraspinatus to evaluate tension on their nutrient arteries in six positions of the arm. Twenty-six shoulders were studied, 22 of which had previously been injected with red latex. Gross dissection, using 4.3 x magnification when necessary, was followed by one MTT for each shoulder (11 LD, 6 TM, 9 combined). The anatomy of the LD and TM neurovascular pedicles was consistent with classic descriptions in 85% of cases; "medialisation" of the thoracodorsal artery was observed in 4 specimens. Tension on the teres major artery was not observed in 15 isolated or combined MTTs, while tension on the thoracodorsal artery in at least one arm position was observed in 60% of 20 isolated or combined MTTs. Three factors were found to be associated with tension: medialisation of the thoracodorsal artery, fixation onto the supraspinatus insertion, and 90 degrees abduction combined with internal rotation. The results suggest that tension on the thoracodorsal artery is possible under certain circumstances when an isolated LD or combined MTT is performed to treat irreparable rotator cuff tear.