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Open Repair of Retracted Latissimus Dorsi Tendon Avulsion
Michael B. Ellman, MD, Adam Yanke, MD, Tristan Juhan, MA, Nikhil N. Verma, MD, Gregory P. Nicholson, MD, Charles Bush-Joseph, MD, and Anthony A. Romeo, MD
Latissimus dorsi avulsion injuries are rarely reported in the literature and are managed with a variety of strategies. Primary anatomical repair of tendon to bone may offer athletes the best chance for successful return to sports.
In this article, we describe a surgical technique for safely repairing an acute or chronic, retracted, avulsed latissimus tendon back to its insertion on the medial aspect of the bicipital groove of the proximal humerus. Using 1 low anterior axillary incision and 1 posterior axillary incision for tendon retrieval when retraction is more than 5 cm, this technique allows for direct anatomical repair of a retracted tendon to bone using 3 points of bony fixation supplemented by soft-tissue repair. The technique also minimizes the risks for neurovascular compromise and cosmetic deformity, while decreasing the risk for postinjury strength deficits.