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

© 2021 The Authors.

Détails bibliographiques
Publié dans:JSES international. - 2020. - 5(2021), 3 vom: 18. Mai, Seite 447-453
Auteur principal: Cartaya, Marco (Auteur)
Autres auteurs: Canales, Pablo, Werthel, Jean-David, Hovsepian, Jean Michel, Valenti, Philippe
Format: Article en ligne
Langue:English
Publié: 2021
Accès à la collection:JSES international
Sujets:Journal Article Irreparable Lower trapezius Rhomboid minor Subscapular Tear Transfer
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520 |a 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 
520 |a 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 
520 |a 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 
520 |a 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 
650 4 |a Journal Article 
650 4 |a Irreparable 
650 4 |a Lower trapezius 
650 4 |a Rhomboid minor 
650 4 |a Subscapular 
650 4 |a Tear 
650 4 |a Transfer 
700 1 |a Canales, Pablo  |e verfasserin  |4 aut 
700 1 |a Werthel, Jean-David  |e verfasserin  |4 aut 
700 1 |a Hovsepian, Jean Michel  |e verfasserin  |4 aut 
700 1 |a Valenti, Philippe  |e verfasserin  |4 aut 
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773 1 8 |g volume:5  |g year:2021  |g number:3  |g day:18  |g month:05  |g pages:447-453 
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