Latismus Dorsi Tendon Transfer to Restore shoulder Abduction; A New Technique
Ashraf N. Moharram, MD; M. M. Hegazy, MD; Mostafa Mahmoud, MD; Ayman Mansour, MD; Ayman Shaheen, MD
Orthopedic Department, Cairo University, Cairo, Egypt
Shoulder abduction is an essential movement for placement of the human hand in space and thus for upper limb function.
The deltoid muscle functions as the main shoulder abductor. In our study we describe a new technique to compensate for loss of deltoid function using a latismus dorsi tendon transfer augmented with an ipsilateral semitendinosis tendon graft. The tendon graft is passed over the acromion and attached to the deltoid insertion. Postoperatively a shoulder spica in 90° abduction was used for six weeks followed by a removable abduction brace for another 6 to 8 weeks. This technique was used in 5 case of loss of deltoid function.
Two of which were isolated axillary nerve injuries while the other 3 were in patients who had a C5 root injury and were treated with a nerve transfer which was unsuccessful in restoring deltoid muscle function. All patients regained active shoulder abduction which averaged 98° (85° to 118°) and were satisfied with the outcome of the procedure. The strength of abduction was measured and compared to the contralateral normal side using a hand-held dynamometer.
The average strength regained was 62% of the normal side. We believe that this procedure can be a useful technique for restoration of a significant range and strength of active shoulder abduction.
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