Pectoralis Major Tendon Transfer

Boatright, Jeffrey D.; Crow, Austin J.; Brockmeier, Stephen F.

doi:10.1007/978-1-4899-7494-5_8

Massive Rotator Cuff Tears 2014

DOI: 10.1007/978-1-4899-7494-5_8

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Pectoralis Major Tendon Transfer

Jeffrey D. Boatright

Austin J. Crow

Stephen F. Brockmeier

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Cited by 2 publications

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“…The prevalence of isolated subscapular tendon ruptures is between 3 and 10% among the total of rotator cuff tears. 5 , 10 , 32 Most of these injuries are repairable. The exact prevalence of irreparable subscapularis tears is difficult to estimate, and nowadays, the surgical treatment continues to be a real challenge for surgeons.…”

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confidence: 99%

Feasibility of lower trapezius and rhomboid minor transfer for irreparable subscapularis tears: an anatomic cadaveric study

Cartaya

Canales

Werthel³

et al. 2021

JSES International

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Background Previously reported outcomes after tendon transfers to reconstruct the subscapularis are unpredictable and often unsatisfactory, especially in the presence of anterior humeral head subluxation. We studied the anatomic feasibility of the lower trapezius and the rhomboid minor transfer to reconstruct irreparable tendon tears of the subscapularis. The aim of this study was to determine the feasibility of lower trapezius and rhomboid minor transfer to reconstruct irreparable subscapularis tendon tears. Materials and methods We measured the tendons dimensions, muscles excursions, distances to pedicles, and dissection needed to complete a successful lower trapezius and/or rhomboid minor transfer to the subscapularis footprint in 10 cadaveric shoulders. The transferred muscles were detached distally, augmented with a semitendinosus and gracilis autograft, and passed anteriorly between the scapula and the subscapularis remnant through a small serratus window to reach the lesser tuberosity. The risk of pedicle compression was subjectively assessed in all cases. Results The trapezius and rhomboid tendons were asymmetric with an average length of 37.6 mm and 21.7 mm, an average width of 63 mm and 33.4 mm, respectively. The mean distances from each distal insertion to the lesser tuberosity were 109 mm for the trapezius and 144 mm for the rhomboid. Mean distances from tendon to pedicle were 57.9 mm and 33.1 mm, respectively. The mean size of the necessary serratus window was 49.4 mm, which was measured at maximal excursion achieved at maximal external rotation 90° representing two digitations. All of the tendon transfers were feasible, and the risk of pedicle compression was 20% for the trapezius and 10% for the rhomboid. Superior migration of the transfer was observed during passive external rotation if the insertion point was too high. Conclusions Transfer of the lower trapezius and rhomboid minor to the lesser tuberosity to reconstruct an irreparable subscapularis tear is feasible without extensive dissection and with a low risk of nerve compression. We recommend not to transfer the rhomboid minor routinely, owing to the risk of tendon luxation after external rotation of the shoulder.

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mentioning

confidence: 99%

Feasibility of lower trapezius and rhomboid minor transfer for irreparable subscapularis tears: an anatomic cadaveric study

Cartaya

Canales

Werthel³

et al. 2021

JSES International

View full text Add to dashboard Cite

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Everything pectoralis major: from repair to transfer

Thompson¹,

Kwon²,

Flatow

et al. 2019

The Physician and Sportsmedicine

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Pectoralis Major Tendon Transfer

Cited by 2 publications

References 57 publications

Feasibility of lower trapezius and rhomboid minor transfer for irreparable subscapularis tears: an anatomic cadaveric study

Feasibility of lower trapezius and rhomboid minor transfer for irreparable subscapularis tears: an anatomic cadaveric study

Everything pectoralis major: from repair to transfer

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