Latissimus dorsi tendon transfer for massive unrepairable rotator cuff tears: A case report

Abstract

Introduction: Massive and irreparable posterior-superior rotator cuff tears present a difficult treatment problem. Chronic rotator cuff tears can cause tendon retraction and fatty atrophy of the muscles. Fullthickness rotator cuff tears involves more than one tendon cause superior migration of the humeral head in relation to the glenoid with altered glenohumeral forces, and ultimately leading to rotator cuff arthropathy. Transfer of the latissimus dorsi muscle is considered a surgical option in the treatment of younger patients without glenohumeral arthritis and with functional deficits caused by an irreparable posterior-superior rotator cuff tear. Presentation of Case: This report presents a case of Right Supraspinatus and Infraspinatus Chronic tear with Subscapularis tear. The case was chronic with non-subsidence of symptoms in spite of conservative treatment. Our treatment in this case consisted of Right Subscapularis and Infraspinatus Repair with Lattisimus Dorsi Transfer to Greater Tubercle. Post operatively ultrasling was used to keep the shoulder in neutral with slight abduction. Rehabilitation protocol was begun after 3 weeks of immobilization. Discussion: Latissimus Dorsi Tendon Transfer has been considered to be a means of restoring function and providing pain relief in patients with irreparable tears involving the infraspinatus and supraspinatus tendons in the absence of substantial glenohumeral arthritis. The aim of this case presentation is to report an example for this case, highlight the difficulties in diagnosis and the treatment options. Conclusion:The Latissimus Dorsi Tendon Transfer for irreparable postero-superior cuff deficiency in selected patients reduce pain and improve shoulder function in the medium term.