Latissimus dorsi transfer for primary treatment of irreparable rotator cuff tears

Abstract

The definition of irreparable tear of the rotator cuff is still controversial. We consider as irreparable those tears in which, after extensive mobilization of the residual tendon cuff, no reinsertion to the humeral tuberosities or to the nearest portion of the anatomical neck of the humerus appears to be possible. This usually occurs when no identifiable tendon tissue is found over the humeral head or when the tendon stumps are so retracted, and often so frayed and friable, that no stitches can be applied to bring the stumps to the area of insertion. In these cases, a transfer of a distant musculotendinous unit is indicated for middle-aged or early elderly patients, when surgery is aimed at restoring a satisfactory active range of shoulder motion and strength, and there appears to be enough compliance by the patient with a long postoperative rehabilitation program.