Experience of Latissimus Dorsi Transfer for Massive Tears of Rotator-Cuff.

We treated 7 shoulders in 7 patients with massive tears of rorator-cuff by the transfer of the latissumus dorsi. They consists of 4 men and 3 women. Their average age was 60 years and the average follow-up was 13 months (10-19).Clinical results were evaluated by R. O. M., complications, the latest complaints, and isokinetic muscle strength measured by the Kin-Com machine. Electromyography and MR imaging were performed on the transferred latissmus dorsi.Active forward flexion improved from a preoperative average of 95° to a postoperative average of 165°. Early complications include shoulder-hand syndrom in 2 shoulders and superficial infection in 1. Recovery of muscle strength was fair in the anterior forward flexion in 3 shoulders. EMG studies revealed the transferred latissimus dorsi were not functioning in the forward flexion and external rotation with the arm at 90° abduction. Rerupture was found in 2 shoulders in the MR image.We conclude that latissimus dorsi transfer can be effective for massive tears of rotator-cuff. But as the muscles show no switching of their functional mechanism, this procedure is not recommended for young and manual workers.