Original Research
Surgical Anatomy of Latissimus Dorsi Muscle in Transfers About the Shoulder
Am J Orthop. 2009 March;38(3):E64-E67
Author and Disclosure Information
Benjamin A. Goldberg, MD, Bassem Elhassan, MD, Steven Marciniak, MD, and Jonathan H. Dunn, MD
Dr. Goldberg is Attending Physician, Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, Illinois.
Dr. Elhassan is Consultant, Mayo Clinic, Rochester, Minnesota.
Dr. Marciniak is Orthopedic Surgeon, Castle Orthopaedics and Sports Medicine, Aurora, Illinois.
Dr. Dunn is Orthopedic Surgeon, Barrington Orthopedic Specialists, Buffalo Grove, Illinois.
Transfer of the latissimus dorsi to the greater tuberosity has been used successfully in the treatment of massive rotator-cuff deficiency. For safe release and transfer of the tendon, the variations in the tendinous insertions of the latissimus dorsi and teres major onto the humerus need to be understood.
In anatomical dissection of 12 cadavers, mean width of the latissimus tendon was 3.3 cm at its insertion, and mean length was 7.3 cm. In all specimens, there were
fascial connections between the latissimus and teres major and between the latissimus and the long head of the triceps.
There were 3 insertion patterns of the latissimus dorsi tendon onto the humerus with respect to the tendon of the teres major: completely separate (8 cadavers), loosely bound (3 cadavers), and completely joined (1 cadaver). If the latissimus dorsi were being transferred in the last type, the teres major would need to be transferred with the latissimus dorsi as a common musculotendinous unit.