Latissimus dorsi tendon transfer for massive rotator cuff tears: a cadaveric study

Area of Science:

• Orthopedic Surgery
• Anatomy
• Biomechanics

Background:

• Massive rotator cuff tears often preclude primary repair to the greater tuberosity.
• Tendon transfer, such as latissimus dorsi tendon (LDT) transfer, is a viable option for restoring shoulder strength when primary repair is not feasible.

Purpose of the Study:

• To define the anatomical relationship between the latissimus dorsi tendon insertion and the axillary and radial nerves.
• To provide critical distance measurements to enhance the safety of LDT transfer procedures.

Main Methods:

• Dissection of ten (10) human cadaver shoulders.
• Measurement of distances from the LDT insertion to the axillary and radial nerves with the arm in various positions (flexion and abduction) and internal rotation.

Main Results:

• The axillary nerve is consistently located superior to the LDT insertion.
• The radial nerve is situated medial and inferior to the LDT insertion.
• Specific distances were recorded: 2.3 cm (axillary) and 2.8 cm (radial) with arm flexed; 1.8 cm (axillary) and 2.0 cm (radial) with arm abducted (both internal rotation).

Conclusions:

• Understanding the precise anatomical course of the axillary and radial nerves relative to the LDT insertion is paramount.
• This anatomical knowledge contributes to minimizing the risk of nerve injury during latissimus dorsi tendon transfer surgery.