Sercan AKPINAR, Mehmet DEMİRHAN, Murat Ali HERSEKLİ, Ata Can ATALAR, Reha N. TANDOĞAN

Tamir edilemeyen rotator manşet yırtıklarının tedavisinde latissimus dorsi transferi

İki erkek hasta (51 ve 57 yaş) kolu kaldıramama ve omuz ağrısı şikayetleriyle başvurdu. Hastalarda aktif öne elevasyon ve abdüksiyon hareketi yoktu. Düşük kol işareti pozitif idi. Çekilen röntgenlerde humerus başında yukarıya göç; manyetik rezonans görüntülerde supraspinatus ve infraspinatus tendonlarında masif yırtık saptandı. Her iki hastada da, tamir edilemeyen, masif rotator manşet yırtığı tanısı ile latissimus dorsi tendon transferi uygulandı. Hastalardan farklı sonuçlar elde edilmekle birlikte, tedavide hasta seçiminin önemli olduğu sonucuna varıldı. Pseudoparalizisi olan hastalarda, latissimus dorsi tendon transferi ile tatminkar sonuç elde etmek güç görünmektedir. Ancak, daha önce cerrahi tedavi görmemiş, deltoid kasının akromiyona yapı.ma yeri sağlam, subskapularisi sağlam hastalarda başarılı sonuçlar elde edilebilmektedir.

Anahtar Kelimeler:

Omuz eklemi, Tendon yaralanmaları, Tendon transferi, Tendonlar, para-artiküler, Rotator manşet

Latissimus dorsi transfer in the treatment of irreparable rotator cuff tears

Two male patients, aged 51 and 57 years, presented with complaints of loss of shoulder elevation and anterior shoulder pain. No active elevation and abduction of the shoulder were observed. Drop arm sign was positive. Plain radiographs revealed superior migration of the humeral head. Magnetic resonance imaging showed massive tears of the supraspinatus and infraspinatus tendons. Latissimus dorsi tendon transfer was performed with the diagnosis of irreparable, massive rotator cuff tears. Different results were obtained from the patients, suggesting that patient selection is crucial for a successful outcome. It seems difficult to obtain satisfactory results by latissimus dorsi transfer in patients with total pseudoparalysis. Nevertheless, the results may be successful in primary rotator cuff tears, in cases without deltoid dehiscence, and in those with intact subscapularis insertion.

Keywords:

Shoulder Joint, Tendon Injuries, Tendon Transfer, Tendons, Para-Articular, Rotator Cuff,

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