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Abstract：
UNASSIGNED: Previously reported outcomes after tendon transfers to reconstruct the subscapularis are unpredictable and often unsatisfactory, especially in the presence of anterior humeral head subluxation. We studied the anatomic feasibility of the lower trapezius and the rhomboid minor transfer to reconstruct irreparable tendon tears of the subscapularis. The aim of this study was to determine the feasibility of lower trapezius and rhomboid minor transfer to reconstruct irreparable subscapularis tendon tears.
UNASSIGNED: We measured the tendons dimensions, muscles excursions, distances to pedicles, and dissection needed to complete a successful lower trapezius and/or rhomboid minor transfer to the subscapularis footprint in 10 cadaveric shoulders. The transferred muscles were detached distally, augmented with a semitendinosus and gracilis autograft, and passed anteriorly between the scapula and the subscapularis remnant through a small serratus window to reach the lesser tuberosity. The risk of pedicle compression was subjectively assessed in all cases.
UNASSIGNED: The trapezius and rhomboid tendons were asymmetric with an average length of 37.6 mm and 21.7 mm, an average width of 63 mm and 33.4 mm, respectively. The mean distances from each distal insertion to the lesser tuberosity were 109 mm for the trapezius and 144 mm for the rhomboid. Mean distances from tendon to pedicle were 57.9 mm and 33.1 mm, respectively. The mean size of the necessary serratus window was 49.4 mm, which was measured at maximal excursion achieved at maximal external rotation 90° representing two digitations. All of the tendon transfers were feasible, and the risk of pedicle compression was 20% for the trapezius and 10% for the rhomboid. Superior migration of the transfer was observed during passive external rotation if the insertion point was too high.
UNASSIGNED: Transfer of the lower trapezius and rhomboid minor to the lesser tuberosity to reconstruct an irreparable subscapularis tear is feasible without extensive dissection and with a low risk of nerve compression. We recommend not to transfer the rhomboid minor routinely, owing to the risk of tendon luxation after external rotation of the shoulder.
UNASSIGNED: We measured the tendons dimensions, muscles excursions, distances to pedicles, and dissection needed to complete a successful lower trapezius and/or rhomboid minor transfer to the subscapularis footprint in 10 cadaveric shoulders. The transferred muscles were detached distally, augmented with a semitendinosus and gracilis autograft, and passed anteriorly between the scapula and the subscapularis remnant through a small serratus window to reach the lesser tuberosity. The risk of pedicle compression was subjectively assessed in all cases.
UNASSIGNED: The trapezius and rhomboid tendons were asymmetric with an average length of 37.6 mm and 21.7 mm, an average width of 63 mm and 33.4 mm, respectively. The mean distances from each distal insertion to the lesser tuberosity were 109 mm for the trapezius and 144 mm for the rhomboid. Mean distances from tendon to pedicle were 57.9 mm and 33.1 mm, respectively. The mean size of the necessary serratus window was 49.4 mm, which was measured at maximal excursion achieved at maximal external rotation 90° representing two digitations. All of the tendon transfers were feasible, and the risk of pedicle compression was 20% for the trapezius and 10% for the rhomboid. Superior migration of the transfer was observed during passive external rotation if the insertion point was too high.
UNASSIGNED: Transfer of the lower trapezius and rhomboid minor to the lesser tuberosity to reconstruct an irreparable subscapularis tear is feasible without extensive dissection and with a low risk of nerve compression. We recommend not to transfer the rhomboid minor routinely, owing to the risk of tendon luxation after external rotation of the shoulder.
摘要：
■先前报道的肌腱移植重建肩胛骨后的结果是不可预测的，通常不能令人满意，尤其是肱骨前头半脱位。我们研究了下斜方肌和菱形小转移重建肩胛骨下不可修复的肌腱撕裂的解剖学可行性。这项研究的目的是确定下斜方肌和菱形小转移重建不可修复的肩胛骨下肌腱撕裂的可行性。
■我们测量了肌腱的尺寸，肌肉运动,到椎弓根的距离，和解剖需要成功完成下斜方肌和/或菱形轻微转移到10具尸体肩部的肩胛骨下足迹。转移的肌肉在远端脱离，用半腱肌和gracilis自体移植增强，并通过一个小的锯齿窗在肩胛骨和肩胛骨下残留物之间向前穿过，到达较小的结节。在所有情况下，均主观评估了椎弓根受压的风险。
■斜方肌和菱形肌腱不对称，平均长度为37.6毫米和21.7毫米，平均宽度为63毫米和33.4毫米，分别。从每个远端插入到较小结节的平均距离对于斜方为109mm，对于菱形为144mm。从肌腱到椎弓根的平均距离为57.9mm和33.1mm，分别。必要锯齿窗的平均尺寸为49.4毫米，在最大外部旋转90°时达到的最大偏移处测量，代表两个数字化。所有的肌腱转移都是可行的，斜方肌和菱形肌的椎弓根压迫风险分别为20%和10%。如果插入点太高，则在被动外部旋转期间观察到转移的优越迁移。
■将下斜方肌和菱形小肌转移到较小的结节以重建不可修复的肩胛骨下撕裂是可行的，无需广泛解剖，并且神经压迫的风险较低。我们建议不要常规转移菱形未成年人，由于肩外旋转后肌腱脱位的风险。
■我们测量了肌腱的尺寸，肌肉运动,到椎弓根的距离，和解剖需要成功完成下斜方肌和/或菱形轻微转移到10具尸体肩部的肩胛骨下足迹。转移的肌肉在远端脱离，用半腱肌和gracilis自体移植增强，并通过一个小的锯齿窗在肩胛骨和肩胛骨下残留物之间向前穿过，到达较小的结节。在所有情况下，均主观评估了椎弓根受压的风险。
■斜方肌和菱形肌腱不对称，平均长度为37.6毫米和21.7毫米，平均宽度为63毫米和33.4毫米，分别。从每个远端插入到较小结节的平均距离对于斜方为109mm，对于菱形为144mm。从肌腱到椎弓根的平均距离为57.9mm和33.1mm，分别。必要锯齿窗的平均尺寸为49.4毫米，在最大外部旋转90°时达到的最大偏移处测量，代表两个数字化。所有的肌腱转移都是可行的，斜方肌和菱形肌的椎弓根压迫风险分别为20%和10%。如果插入点太高，则在被动外部旋转期间观察到转移的优越迁移。
■将下斜方肌和菱形小肌转移到较小的结节以重建不可修复的肩胛骨下撕裂是可行的，无需广泛解剖，并且神经压迫的风险较低。我们建议不要常规转移菱形未成年人，由于肩外旋转后肌腱脱位的风险。
