Strengthening of the Partially Paralyzed Shoulder Girdle by Multiple Muscle-Tendon Transfers

Goldner, J. Leonard

doi:10.1016/s0749-0712(21)01147-1

Cited by 23 publications

(3 citation statements)

References 9 publications

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“…The described techniques mostly involve some form of osteotomy of the spine of the scapula, acromion, or clavicle with detachment of the deltoid, transposition of the acromion to the humerus, as well as reinsertion of the deltoid on the trapezius. The reported improvements in abduction seem minor at first, however, still can be considered quite impressive giving the adverse initial situation with true muscle paralysis including the deltoid muscle [1, 3–5, 13, 20, 22, 25, 29, 30]. The initial situation in patients with ISTTs usually involves pain as well as loss of strength and limited motion [35] but typically shows a still functioning deltoid muscle.…”

Section: Discussionmentioning

confidence: 99%

“…While the transfer of the upper trapezius instead of the pectoralis major transfer to replace an irreparable subscapularis tendon has rendered unsatisfactory outcomes [14], the transfer of the lower trapezius instead of the latissimus dorsi transfer to replace an irreparable infraspinatus tendon showed promising early results [11]. In addition, trapezius transfers have been performed since many years in patients with brachial plexus palsies and deltoid muscle insufficiencies in order to counteract abduction paralysis [1, 3–5, 13, 20, 22, 25, 29–31]. Early descriptions date even back to Hoffa in 1891, Lewis in 1910 and Lange in 1911 [8].…”

Section: Discussionmentioning

confidence: 99%

“…While trapezius transfers have been previously used for paralytic patients due to brachial plexus palsies and deltoid muscle inactivity [1, 3–5, 13, 20, 22, 25, 29, 30], a transfer of the middle trapezius to treat patients with ISTT has so far not been described. Therefore, the purpose of this study was to investigate the anatomical feasibility of a middle trapezius transfer below the acromion to substitute the supraspinatus.…”

Section: Introductionmentioning

confidence: 99%

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Middle trapezius transfer for treatment of irreparable supraspinatus tendon tears- anatomical feasibility study

et al. 2021

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Purpose The purpose of this study was to investigate the anatomical feasibility of a middle trapezius transfer below the acromion for treatment of irreparable supraspinatus tendon tears. Methods This study involved 20 human cadaveric shoulders in 10 full-body specimens. One shoulder in each specimen was dissected and assessed for muscle and tendon extent, force vectors, and distance to the neurovascular structures. The opposite shoulder was used to evaluate the surgical feasibility of the middle trapezius transfer via limited skin incisions along with an assessment of range of motion and risk of neurovascular injury following transfer. Results The harvested acromial insertion of the middle trapezius tendon showed an average muscle length of 11.7 ± 3.0 cm, tendon length of 2.7 ± 0.9 cm, footprint length of 4.3 ± 0.7 cm and footprint width of 1.4 ± 0.5 cm. The average angle between the non-transferred middle trapezius transfer and the supraspinatus was 33 ± 10° in the transversal plane and 34 ± 14° in the coronal plane. The mean distance from the acromion to the neurovascular bundle was 6.3 ± 1.3 cm (minimum: 4.0 cm). During surgical simulation there was sufficient excursion of the MTT without limitation of range of motion in a retracted scapular position but not in a protracted position. No injuries to the neurovascular structures were noted. Conclusion Transfer of the acromial portion of the middle trapezius for replacement of an irreparable supraspinatus seems to be feasible in terms of size, vector, excursion, mobility and safety. However, some concern regarding sufficiency of transfer excursion remains as scapula protraction can increase the pathway length of the transfer. Level of evidence Basic Science Study/Anatomical Study

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Middle trapezius transfer for treatment of irreparable supraspinatus tendon tears- anatomical feasibility study

et al. 2021

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Tendon Transfers of the Shoulder, Elbow, Wrist, and Hand

Wagner

Elhassan

Daly

2021

Operative Brachial Plexus Surgery

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Modifizierte Technik der Verpflanzung des Musculus trapezius zur Funktionsverbesserung bei Armplexusschäden

Rühmann

Kohn²,

Bohnsack

2008

Orthop Traumatol

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The procedure was performed in 104 cases. 80 patients were followed up on average after 2.4 years (0.8-8 years). In all cases, the transfer resulted in an increase of function and in 95% in a decrease of multidirectional shoulder instability. The modification of the original technique in the latest 22 cases was superior in terms of shoulder stability. In all these cases, a decrease of instability was achieved and inferior subluxation was abolished.

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Strengthening of the Partially Paralyzed Shoulder Girdle by Multiple Muscle-Tendon Transfers

Cited by 23 publications

References 9 publications

Middle trapezius transfer for treatment of irreparable supraspinatus tendon tears- anatomical feasibility study

Middle trapezius transfer for treatment of irreparable supraspinatus tendon tears- anatomical feasibility study

Tendon Transfers of the Shoulder, Elbow, Wrist, and Hand

Modifizierte Technik der Verpflanzung des Musculus trapezius zur Funktionsverbesserung bei Armplexusschäden

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