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Related Concept Videos

Muscles that Move the Arm01:31

Muscles that Move the Arm

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Nine muscles are involved in arm movements. Two of these, the pectoralis major and latissimus dorsi, originate from the axial skeleton and are called axial muscles. The other seven originate from the scapula and are called the scapular muscles.
The pectoralis major has two origins. Its clavicular head originates on the medial half of the clavicle. In contrast, the sternocostal head originates on the costal cartilages of ribs 1-6, the sternum, and the aponeurosis of the external oblique of the...
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Spinal Nerves: Plexus I01:22

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Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
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Related Experiment Video

Updated: Sep 10, 2025

Surface Electromyographic Biofeedback as a Rehabilitation Tool for Patients with Global Brachial Plexus Injury Receiving Bionic Reconstruction
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Split Latissimus Dorsi Tendon Transfer for External Rotation in Obstetrical Brachial Plexus Injury.

Aleksandar Lovic1, Javier Pérez-Rodríguez

  • 1Plastic and Reconstructive Surgery, La Paz University Hospital, Madrid, Spain.

Techniques in Hand & Upper Extremity Surgery
|August 20, 2025
PubMed
Summary

This study presents a modified latissimus dorsi tendon transfer for improved shoulder external rotation. The technique utilizes the muscle's dual innervation to enhance rotation and stability without limiting internal rotation.

Keywords:
brachial plexus birth injuryexternal rotation tendon transferlatissimus dorsi tendon transfersegmentally innervated latissimus dorsisplit latissimus dorsi transfer

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Area of Science:

  • Orthopedic Surgery
  • Musculoskeletal Research
  • Reconstructive Surgery

Background:

  • The latissimus dorsi muscle has a unique intramuscular neurovascular branching pattern.
  • This pattern allows for two independent motor flaps, offering potential for dual functionality.

Purpose of the Study:

  • To propose and evaluate a modified latissimus dorsi tendon transfer technique for improving shoulder external rotation.
  • To assess the efficacy of using the medial and lateral parts of the latissimus dorsi for distinct functional roles in shoulder reconstruction.

Main Methods:

  • A retrospective review of patients undergoing the modified latissimus dorsi tendon transfer was conducted.
  • Analysis included active and passive ranges of motion for external rotation and Mallet scores.
  • Complications and limitations to internal rotation were specifically examined.

Main Results:

  • Significant postoperative increases in active external rotation were observed in both abduction (3° to 78°) and adduction (1° to 37°).
  • Mallet scores improved significantly for global abduction, external rotation, hand-to-neck, and hand-to-mouth motions.
  • Average shoulder abduction active range of motion was 140°, with no significant change in hand-on-spine score.

Conclusions:

  • The modified latissimus dorsi tendon transfer is effective for optimizing external rotation reconstruction.
  • The technique leverages the muscle's anatomy for a dual transfer, enhancing function while limiting morbidity and internal rotation limitations.