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Offener Latissimus-dorsi-Transfer – Indikation und Technik

Open latissimus dorsi transfer—indication and technique

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Zusammenfassung

Kommt es im Fall eines irreparablen posterosuperioren Rotatorenmanschettendefekts neben Schmerzen zu einem relevanten aktiven Funktionsausfall der Schulter, insbesondere in Außenrotation, kann als effektive Behandlungsoption ein Sehnentransfer vom M. latissimus dorsi in Betracht gezogen werden. In Abhängigkeit vom Patientenalter, der gegebenen anatomischen Verhältnisse und der Schulterrestfunktion sind die Indikation und ein operatives Vorgehen sorgfältig zu prüfen. Der Transfer kann sowohl offen als auch arthroskopisch assistiert durchgeführt werden. Mit einem endgültigen Funktionsresultat kann erst nach 2 Jahren gerechnet werden. Eine Progression in der Entwicklung einer Cuff-Arthropathie wurde im Langzeitverlauf beobachtet, der Sehnentransfer vom M. latissimus dorsi kann jedoch eine prothetische Versorgung insbesondere bei jüngeren Patienten hinauszögern.

Abstract

In cases of irreparable posterosuperior rotator cuff tears, patients suffer from pain and loss of shoulder function particularly in outer rotation. Latissimus dorsi transfer can lead to improvement in overall shoulder pain and function. Open or arthroscopy-assisted tendon transfer is possible but correct indication for successful treatment is essential. Definite results and outcome after latissimus dorsi transfer can be expected two years after surgery. Progression of cuff tear arthropathy is possible but successful tendon transfer of latissimus dorsi might delay need for a prosthesis especially in young patients.

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Authors and Affiliations

  1. Universitätsklinik für Orthopädische Chirurgie und Traumatologie, Inselspital Bern, 3010, Bern, Schweiz

    Johannes Weihs, Lilianna Bolliger &  Matthias A. Zumstein

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  1. Johannes Weihs
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  2. Lilianna Bolliger
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  3. Matthias A. Zumstein
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Correspondence to Johannes Weihs or Matthias A. Zumstein.

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J. Weihs, L. Bolliger und M.A. Zumstein geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Weihs, J., Bolliger, L. & Zumstein, M.A. Offener Latissimus-dorsi-Transfer – Indikation und Technik. Obere Extremität 13, 255–260 (2018). https://doi.org/10.1007/s11678-018-0476-y

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