Latissimus Dorsi Transfer for the Treatment of Irreparable Tears of the Rotator Cuff

Sixteen irreparable, massive rotator cuff tears were treated with latissimus dorsi transfer and reviewed after an average of 33 months. There were no neurovascular complications or infections. Pain relief was satisfactory in 94% of the shoulders at rest and in 81% on exertion. Flexion was 83 degrees preoperatively and 135 degrees postoperatively. The functional value of the shoulder averaged 73% of an age- and gender-adjusted normal score. For the 12 shoulders with a functional subscapularis, it averaged 82%; for those four without a functioning subscapularis, 48%. If the subscapularis was torn and could not be adequately repaired, latissimus dorsi transfer was of no value. In cases with good subscapularis function but irreparable defects in the external rotator tendons, restoration of approximately 80% of normal shoulder function was obtained, indicating that latissimus dorsi transfer is a safe and valuable alternative for the treatment of this specific type of irreparable rotator cuff tear.