Potential excursion and relative tension of muscles in the shoulder girdle: Relevance to tendon transfers

Herzberg, Guillaume; Urien, J.-P.; Dimnet, J.

doi:10.1016/s1058-2746(99)90072-1

Cited by 125 publications

(84 citation statements)

References 14 publications

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“…Taking this marginal gain of external rotation into account, some authors argued combined transfer of latissimus dorsi and teres major tendons might lead to increased restoration of active external rotation resulting from a more powerful transfer [3,14]. This difference in external rotation might not be permanent as seen with the loss of external rotation between 2 and 5 years in our patients.…”

Section: Discussionmentioning

confidence: 70%

Modified L'Episcopo Tendon Transfers for Irreparable Rotator Cuff Tears: 5-year Followup

Gerhardt

Lehmann

Lichtenberg³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Patients with posterosuperior cuff tears lose functional external rotation of the shoulder. Latissimus dorsi and teres major transfer is performed to restore external rotation. Twenty patients with a mean age was 55.8 ± 6 years underwent this procedure and were examined at averages of 24.7 (n = 17) and 70.6 (n = 13) months. Two patients did not improve presumably because of failure of the transfer. The Constant and Murley score increased from 55.6 to 90.4 after 2 years and to 87.9 after 5 years. The mean active flexion increased from 119.4°to 169.3°and reached 170°after 5 years, and mean external rotation increased from 12°to 35°, finally reaching 23°.

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Section: Discussionmentioning

confidence: 70%

Modified L'Episcopo Tendon Transfers for Irreparable Rotator Cuff Tears: 5-year Followup

Gerhardt

Lehmann

Lichtenberg³

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Moreover, the passage of the LD/TM tendons around the posterior aspect of the humerus is facilitated by its dislocation when performing the RSA; the course of the rerouted LD/TM tendon is short and horizontal, facilitating reattachment to the posterolateral aspect of the humerus, providing an ideal vector for external rotation (Figs. 3, 4) [27,41]. Our preference is to reattach both tendons at the teres minor insertion with transosseous sutures passing around the stem prosthesis, as this offers the best mechanical advantage to restore external rotation [26,40].…”

Section: Discussionmentioning

confidence: 99%

Reverse Shoulder Arthroplasty Combined with a Modified Latissimus Dorsi and Teres Major Tendon Transfer for Shoulder Pseudoparalysis Associated with Dropping Arm

Boileau

Chuinard

Roussanne

et al. 2008

Clinical Orthopaedics &Amp; Related Research

186

132

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Although a reverse shoulder arthroplasty (RSA) can restore active elevation in the cuff deficient shoulder, it cannot restore active external rotation when both the infraspinatus and teres minor muscles are absent or atrophied. We hypothesized that a latissimus dorsi and teres major (LD/TM) transfer with a concomitant RSA would restore shoulder function and activities of daily living (ADLs). We prospectively followed 11 consecutive patients (mean age, 70 years) with a combined loss of active elevation and external rotation (shoulder pseudoparalysis and dropping arm) who underwent this procedure. All had severe cuff tear arthropathy (Hamada Stage 3, 4, or 5) and severe atrophy or fatty infiltration of infraspinatus and teres minor on preoperative MRI or CT-scan.

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“…The tendon is useful for transfer as it has 33.9 cm of excursion and has a predictable insertion anterior to the teres major tendon and 7 mm lateral [23,24]. Initially, latissimus dorsi tendon transfers were used to treat patients with brachial plexopathies who lacked external rotation.…”

Section: Latissimus Dorsi Transfermentioning

confidence: 99%

“…The pectoralis major tendon is also useful for transfer as it has the second longest excursion of 18.8 cm [24]. Indications for pectoralis major transfer are similar to latissimus transfer, however, generally this procedure is reserved for patients with more severe weakness caused by anterosuperior RCTs.…”

Section: Pectoralis Major Transfermentioning

confidence: 99%

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2016

MOJOR

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Irreparable rotator cuff tears are a challenging problem facing orthopedic surgeons. Multiple treatment strategies have been proposed depending on patient factors such as age, activity, and the quality of the rotator cuff tendon. The clinical presentation of a patient with an irreparable rotator cuff tear is variable with respect to pain, function, and disability, necessitating a thorough, detailoriented clinical evaluation. Initial imaging should include plain radiographs and magnetic resonance imaging (MRI) to evaluate tendon quality. Computed tomography (CT) arthrography may be used if MRI is contraindicated. Non operative treatment is generally reserved for low demand patients with minimal pain, while debridement, partial-repair, and subacromial decompression with or without biceps tenodesis versus tenotomy have been advocated in low demand patients with significant pain. However, these treatment modalities often result in unpredictable and marginal improvements in functional outcomes. Tendon transfers including the latissimus dorsi, pectoralis major, and trapezius muscles have been used to improve function. Scaffold devices have more recently been used as a biologic patch graft and augment. Superior capsule reconstruction is a novel technique that has been shown to restore glenohumeral stability. Reverse total shoulder arthroplasty and hemiarthroplasty can be used as salvage options in patients with rotator cuff tear arthropathy. Keywords:

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Potential excursion and relative tension of muscles in the shoulder girdle: Relevance to tendon transfers

Cited by 125 publications

References 14 publications

Modified L'Episcopo Tendon Transfers for Irreparable Rotator Cuff Tears: 5-year Followup

Modified L'Episcopo Tendon Transfers for Irreparable Rotator Cuff Tears: 5-year Followup

Reverse Shoulder Arthroplasty Combined with a Modified Latissimus Dorsi and Teres Major Tendon Transfer for Shoulder Pseudoparalysis Associated with Dropping Arm

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