肩腱板広範囲断裂に対する広背筋移行術の経験 Latissimus Dorsi Transfer for Massive Rotator Cuff Tears

Very large tears of the rotator cuff may be irreparable. Several reconstruction methods have been reported. We have performed the Latissimus Dorsi (LD) transfer described by Gerber (1988)for the treatment of irreparable massive rotator cuff tears.<br>Since 1991,13 shoulders in 11 cases with a irreparable massive rotator cuff tear have been treated with LD transfer. They consist of 10 males and a female with an average age of 64 years (range 49 to 81 years). An average follow-up is 25 months. These cases were evaluated by JOA shoulder score and EMG analysis.<br>Pain was improved in all cases. Active flexion averaged 104°preoperatively and 139°(range 50°to 180°)postoperatively. There were no complication. JOA shoulder score averaged 60 points preoperatively and 79 points postoperatively. Electromyographic analysis revealed that transfered LD was acting more with the abducted arm than the arm at the side. On flexion, apparent contraction was observed over 900°<br>The LD transfer relieves pain and aids functional recovery of the shoulder with massive rotator cuff tear. This procedure may act as not only rapair of the cuff but also reconstruction of the shoulder function.