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Influence of fixation point of latissimus dorsi tendon transfer for irreparable rotator cuff tear on glenohumeral external rotation: A cadaver study.
Orthop Traumatol Surg Res 2016; 102(8):971-975OT

Abstract

Latissimus dorsi tendon transfer is a surgical option for treating irreparable posterosuperior rotator cuff tears, notably when attempting to reconstruct active external rotation. We hypothesized that the positioning of the transfer's point of fixation would differ depending on the desired elbow-to-body external rotation or external rotation with the elbow abducted.

MATERIAL AND METHODS

Seven shoulders from four whole frozen cadavers were used. We created two systems to install the subject in a semi-seated position to allow external rotation elbow to body and the arm abducted 90°. Traction sutures were positioned on the latissimus dorsi muscle and a massive tear of the rotator cuff was created. We tested six different transfer positions. Muscle contraction of the latissimus dorsi was stimulated using 10-N and 20-N suspended weights.

RESULTS

The point of fixation of the latissimus dorsi on the humeral head had an influence on the elbow-to-body external rotation and with 90° abduction (P<0.001). The fixation point for a maximum external rotation with the elbow to the body was the anterolateral position (P<0.016). The fixation point for a maximum external rotation at 90° abduction was the position centered on the infraspinatus footprint (P<0.078).

CONCLUSION

The optimal point of fixation differs depending on whether external rotation is restored at 0° or 90° abduction.

LEVEL OF EVIDENCE

Fundamental study, anatomic study.

Authors+Show Affiliations

Le Confluent-Nouvelles Cliniques Nantaises, Nantes, France. Electronic address: dr.bargoin@gmail.com.Centre Hospitalier Universitaire, Nantes, France.Clinique de l'Union, Saint Jean, France.Institut de recherche en chirurgie orthopédique et sportive, Paris, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28341266

Citation

Bargoin, K, et al. "Influence of Fixation Point of Latissimus Dorsi Tendon Transfer for Irreparable Rotator Cuff Tear On Glenohumeral External Rotation: a Cadaver Study." Orthopaedics & Traumatology, Surgery & Research : OTSR, vol. 102, no. 8, 2016, pp. 971-975.
Bargoin K, Boissard M, Kany J, et al. Influence of fixation point of latissimus dorsi tendon transfer for irreparable rotator cuff tear on glenohumeral external rotation: A cadaver study. Orthop Traumatol Surg Res. 2016;102(8):971-975.
Bargoin, K., Boissard, M., Kany, J., & Grimberg, J. (2016). Influence of fixation point of latissimus dorsi tendon transfer for irreparable rotator cuff tear on glenohumeral external rotation: A cadaver study. Orthopaedics & Traumatology, Surgery & Research : OTSR, 102(8), pp. 971-975. doi:10.1016/j.otsr.2016.09.012.
Bargoin K, et al. Influence of Fixation Point of Latissimus Dorsi Tendon Transfer for Irreparable Rotator Cuff Tear On Glenohumeral External Rotation: a Cadaver Study. Orthop Traumatol Surg Res. 2016;102(8):971-975. PubMed PMID: 28341266.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of fixation point of latissimus dorsi tendon transfer for irreparable rotator cuff tear on glenohumeral external rotation: A cadaver study. AU - Bargoin,K, AU - Boissard,M, AU - Kany,J, AU - Grimberg,J, Y1 - 2016/10/27/ PY - 2015/12/20/received PY - 2016/08/20/revised PY - 2016/09/05/accepted PY - 2017/3/26/entrez PY - 2017/3/28/pubmed PY - 2017/10/20/medline KW - Cadaver study KW - Joint range of movement KW - Latissimus dorsi KW - Rotator cuff tear KW - Tendon transfer SP - 971 EP - 975 JF - Orthopaedics & traumatology, surgery & research : OTSR JO - Orthop Traumatol Surg Res VL - 102 IS - 8 N2 - : Latissimus dorsi tendon transfer is a surgical option for treating irreparable posterosuperior rotator cuff tears, notably when attempting to reconstruct active external rotation. We hypothesized that the positioning of the transfer's point of fixation would differ depending on the desired elbow-to-body external rotation or external rotation with the elbow abducted. MATERIAL AND METHODS: Seven shoulders from four whole frozen cadavers were used. We created two systems to install the subject in a semi-seated position to allow external rotation elbow to body and the arm abducted 90°. Traction sutures were positioned on the latissimus dorsi muscle and a massive tear of the rotator cuff was created. We tested six different transfer positions. Muscle contraction of the latissimus dorsi was stimulated using 10-N and 20-N suspended weights. RESULTS: The point of fixation of the latissimus dorsi on the humeral head had an influence on the elbow-to-body external rotation and with 90° abduction (P<0.001). The fixation point for a maximum external rotation with the elbow to the body was the anterolateral position (P<0.016). The fixation point for a maximum external rotation at 90° abduction was the position centered on the infraspinatus footprint (P<0.078). CONCLUSION: The optimal point of fixation differs depending on whether external rotation is restored at 0° or 90° abduction. LEVEL OF EVIDENCE: Fundamental study, anatomic study. SN - 1877-0568 UR - https://www.unboundmedicine.com/medline/citation/28341266/Influence_of_fixation_point_of_latissimus_dorsi_tendon_transfer_for_irreparable_rotator_cuff_tear_on_glenohumeral_external_rotation:_A_cadaver_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1877-0568(16)30150-5 DB - PRIME DP - Unbound Medicine ER -