Variants of latissimus dorsi with a perspective on tendon transfer surgery: An anatomic study

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Abstract

Background: The latissimus dorsi (LD) is often used for tendon transfers to treat massive irreparable posterosuperior rotator cuff tears. The operation requires the LD tendon to be mobilized to reduce tension on the tendon. In that respect, any connection between the LD tendon and contiguous muscles may hamper tendon mobility and affect the surgical outcome. The goal of this study was to document the occurrence of connections between the LD and adjacent muscles and nerves. Methods: We studied the scapular region on 48 embalmed cadavers. The skin and superficial fascia were removed according to Cunningham's manual of dissection, and the muscle was exposed. Results: It was found that the LD and teres major (TM) muscles are connected by muscle fibers in 10% of the cadavers studied. Another vital discovery was that in some cadavers, the LD tendon was penetrated by a nerve. Conclusion: Fascial connections between the LD and TM are well known, but these muscle links are comparatively unusual. From the results of this study, one should pay particular attention to muscle links between the LD and TM during dissection of the LD for transfer. It can also be suggested that during transfer surgery, the LD tendon should be cautiously examined for the possibility of a nerve penetrating it.

Original languageEnglish
JournalJournal of Shoulder and Elbow Surgery
DOIs
Publication statusPublished - 2018

Fingerprint

Tendon Transfer
Superficial Back Muscles
Tendons
Muscles
Cadaver
Dissection
Subcutaneous Tissue

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{6019f7c3e39046bc8b0aac7631c658d0,
title = "Variants of latissimus dorsi with a perspective on tendon transfer surgery: An anatomic study",
abstract = "Background: The latissimus dorsi (LD) is often used for tendon transfers to treat massive irreparable posterosuperior rotator cuff tears. The operation requires the LD tendon to be mobilized to reduce tension on the tendon. In that respect, any connection between the LD tendon and contiguous muscles may hamper tendon mobility and affect the surgical outcome. The goal of this study was to document the occurrence of connections between the LD and adjacent muscles and nerves. Methods: We studied the scapular region on 48 embalmed cadavers. The skin and superficial fascia were removed according to Cunningham's manual of dissection, and the muscle was exposed. Results: It was found that the LD and teres major (TM) muscles are connected by muscle fibers in 10{\%} of the cadavers studied. Another vital discovery was that in some cadavers, the LD tendon was penetrated by a nerve. Conclusion: Fascial connections between the LD and TM are well known, but these muscle links are comparatively unusual. From the results of this study, one should pay particular attention to muscle links between the LD and TM during dissection of the LD for transfer. It can also be suggested that during transfer surgery, the LD tendon should be cautiously examined for the possibility of a nerve penetrating it.",
author = "Ranade, {Anu V.} and Rajalakshmi Rai and Rai, {Ashwin R.} and Dass, {Prameela M.} and Pai, {Mangala M.} and Rajanigandha Vadgaonkar",
year = "2018",
doi = "10.1016/j.jse.2017.06.046",
language = "English",
journal = "Journal of Shoulder and Elbow Surgery",
issn = "1058-2746",
publisher = "Mosby Inc.",

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TY - JOUR

T1 - Variants of latissimus dorsi with a perspective on tendon transfer surgery

T2 - An anatomic study

AU - Ranade, Anu V.

AU - Rai, Rajalakshmi

AU - Rai, Ashwin R.

AU - Dass, Prameela M.

AU - Pai, Mangala M.

AU - Vadgaonkar, Rajanigandha

PY - 2018

Y1 - 2018

N2 - Background: The latissimus dorsi (LD) is often used for tendon transfers to treat massive irreparable posterosuperior rotator cuff tears. The operation requires the LD tendon to be mobilized to reduce tension on the tendon. In that respect, any connection between the LD tendon and contiguous muscles may hamper tendon mobility and affect the surgical outcome. The goal of this study was to document the occurrence of connections between the LD and adjacent muscles and nerves. Methods: We studied the scapular region on 48 embalmed cadavers. The skin and superficial fascia were removed according to Cunningham's manual of dissection, and the muscle was exposed. Results: It was found that the LD and teres major (TM) muscles are connected by muscle fibers in 10% of the cadavers studied. Another vital discovery was that in some cadavers, the LD tendon was penetrated by a nerve. Conclusion: Fascial connections between the LD and TM are well known, but these muscle links are comparatively unusual. From the results of this study, one should pay particular attention to muscle links between the LD and TM during dissection of the LD for transfer. It can also be suggested that during transfer surgery, the LD tendon should be cautiously examined for the possibility of a nerve penetrating it.

AB - Background: The latissimus dorsi (LD) is often used for tendon transfers to treat massive irreparable posterosuperior rotator cuff tears. The operation requires the LD tendon to be mobilized to reduce tension on the tendon. In that respect, any connection between the LD tendon and contiguous muscles may hamper tendon mobility and affect the surgical outcome. The goal of this study was to document the occurrence of connections between the LD and adjacent muscles and nerves. Methods: We studied the scapular region on 48 embalmed cadavers. The skin and superficial fascia were removed according to Cunningham's manual of dissection, and the muscle was exposed. Results: It was found that the LD and teres major (TM) muscles are connected by muscle fibers in 10% of the cadavers studied. Another vital discovery was that in some cadavers, the LD tendon was penetrated by a nerve. Conclusion: Fascial connections between the LD and TM are well known, but these muscle links are comparatively unusual. From the results of this study, one should pay particular attention to muscle links between the LD and TM during dissection of the LD for transfer. It can also be suggested that during transfer surgery, the LD tendon should be cautiously examined for the possibility of a nerve penetrating it.

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