Latissimus Dorsi Tendon Repair Through Single-Incision Axillary Approach Using All-Suture Anchor Tension Slide

This case report and technical note details the successful surgical repair of a latissimus dorsi (LD) tendon rupture in a high-demand athlete using a single-incision axillary approach with an all-suture anchor tension slide technique. The patient, a 38-year-old competitive athlete, sustained the injury during a Spartan Race, presenting with substantial functional limitations, including shoulder weakness and impaired performance in athletic and professional activities. Clinical and imaging findings confirmed a complete LD tendon rupture with 6 cm of retraction and associated teres major partial tearing. Surgical repair involved tendon mobilization, preparation of the humeral footprint, and fixation with all-suture anchors in a tension slide configuration. Postoperatively, the patient underwent a tailored rehabilitation protocol, achieving near-complete return to preinjury function by 7 months. This innovative technique offered advantages, including cosmetic incision, minimized surgical morbidity, and familiarity with sports surgeons' techniques. The all-suture anchors avoid metal implants, reduce bone loss, and simplify the procedure compared to cortical buttons. Although effective, the approach requires technical expertise, particularly in mitigating neurovascular risks. This report underscores the efficacy and reproducibility of this method in treating LD tendon ruptures in high-demand athletes. Further biomechanical and clinical comparisons are warranted to refine surgical indications and optimize outcomes.