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Rademaker E, Beekhuizen SR, Bos C, van der Zwaal P. Early surgical repair of combined latissimus dorsi and teres major avulsion. BMJ Case Rep 2023; 16:e254158. [PMID: 38056927 PMCID: PMC10711931 DOI: 10.1136/bcr-2022-254158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
A combined avulsion of both the latissimus dorsi muscle and teres major muscle is a rare occurrence and data focused on the treatment of this type of injury is limited to case studies and series. This case report presents the outcomes of early surgical repair for avulsions of the latissimus dorsi and teres major tendons in a high-demanding athlete. The patient underwent surgical repair using a single incision technique and endosteal button fixation of the avulsed tendons. This procedure was performed within 4 weeks of the initial injury, followed by a progressive mobilisation regimen in the postoperative phase. After a period of 3 months, the patient successfully participated in his first international competition. This report describes the effectiveness of early surgical repair after latissimus dorsi and teres major tendon avulsion. The single incision technique and the use of endosteal buttons for tendon fixation yielded excellent results for a professional judoka.
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Affiliation(s)
- Eva Rademaker
- Department of Trauma Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | | | - Cynthia Bos
- National Judo Federation, Nieuwegein, The Netherlands
| | - Peer van der Zwaal
- Orthopaedics, Medisch Centrum Haaglanden Antoniushove, Leidschendam, The Netherlands
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Belk JW, Bravman JT, Frank RM, Seidl AJ, McCarty EC. Latissimus Dorsi Tendon Repair. VIDEO JOURNAL OF SPORTS MEDICINE 2022. [DOI: 10.1177/26350254221128040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Latissimus dorsi tendon ruptures are rare injuries that can occur in overhead or throwing motions and are almost always sports related. Indications: Latissimus dorsi tendon ruptures are largely treated nonoperatively, although surgical repair is indicated for the young active patient looking to return to a high level of sport and for those with complete avulsion injuries or mid-substance tendon tears. Technique Description: Depending on the degree of tendon retraction, anteroinferior or posteroinferior axillary incision is made. After the tendon is mobilized, sutures are placed in a Krackow fashion through the bulk of the tendon, and the tendon footprint is prepared by gently decorticating the surface of the humerus, just anterior and inferior to the teres major insertion point. Two Arthrex Pec Buttons are then loaded into the superior and inferior limbs of the suture tape and 2 unicortical holes are drilled into the footprint of the insertion site. The superior button is placed first and then tensioned to allow the latissimus dorsi to be pulled to the bone. Next, the second button is placed, though this is not tensioned until later at the time of the biceps tenodesis. Finally, the procedure is visualized and well inspected to ensure appropriate location of the tendon and securing hardware. Results: After an appropriate rehabilitation protocol is followed for up to 6 months postoperatively, acute repair of a ruptured latissimus dorsi tendon allows for near to complete restoration of patient functionality and strength, with return to full activity possible within 6 to 8 months. Conclusion: Surgical repair of a ruptured latissimus dorsi tendon is effective in restoring upper extremity strength and functionality and is associated with high patient satisfaction. The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
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Affiliation(s)
- John W. Belk
- Department of Orthopedics, University of Colorado School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Jonathan T. Bravman
- Department of Orthopedics, University of Colorado School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Rachel M. Frank
- Department of Orthopedics, University of Colorado School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Adam J. Seidl
- Department of Orthopedics, University of Colorado School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Eric C. McCarty
- Department of Orthopedics, University of Colorado School of Medicine, University of Colorado, Aurora, Colorado, USA
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Ahmad AN, Hankins DA, Wascher DC. Simultaneous Bilateral Latissimus Dorsi Tendon Ruptures: A Case Report. JBJS Case Connect 2021; 11:01709767-202112000-00017. [PMID: 34669616 DOI: 10.2106/jbjs.cc.21.00091] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE We report a case of a 55-year-old man who sustained bilateral, complete latissimus dorsi tendon ruptures during a water-skiing accident. Physical examination and magnetic resonance imaging confirmed the patient's diagnosis but also revealed a tear of the teres major on the left side. Staged primary repair was performed on each side, with a 6-week interval between procedures. At 1-year follow-up, the patient had an excellent clinical outcome. CONCLUSION Staged surgical repair of bilateral latissimus dorsi tendon ruptures can be performed, leading to excellent clinical and functional outcomes for patients.
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Affiliation(s)
- Aamir N Ahmad
- Department of Orthopaedics and Rehabilitation, University of New Mexico School of Medicine, Albuquerque, New Mexico
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Goodloe JB, Oldenburg KS, Pike JM, Eichinger JK. Single incision latissimus dorsi surgical technique: a three button repair. JSES REVIEWS, REPORTS, AND TECHNIQUES 2021; 1:213-217. [PMID: 37588954 PMCID: PMC10426704 DOI: 10.1016/j.xrrt.2021.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Due to the infrequent occurrence of latissimus dorsi insertional avulsions or tendon ruptures, there is no clear evidence on the optimal surgical fixation strategy. A three suture unicortical button repair technique through a single incision offers an anatomic reconstruction of the broad insertional footprint with adequate exposure. This fixation strategy is the preferred technique by the senior author.
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Chalmers P, Erickson B, Romeo A. Latissimus Dorsi and Teres Major Injuries. OPER TECHN SPORT MED 2021. [DOI: 10.1016/j.otsm.2021.150805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Latissimus dorsi tendon ruptures are less-common injuries that can occur in elite throwing athletes. Physical examination of the thrower with a latissimus injury may show ecchymosis of the upper arm and asymmetry of the posterior axillary fold along with possible weakness in shoulder adduction, extension, and internal rotation. Magnetic resonance imaging is used to confirm the diagnosis. Latissimus tendon ruptures are largely treated nonoperatively; surgical repair is only advocated for in professional throwing athletes with complete avulsion injuries or midsubstance latissimus tendon tears. Surgical repair options include the use of suture anchors, cortical suture buttons, or transosseous sutures via a single posterior axillary incision or a 2-incision technique. Given the limited literature on this topic, there have been no studies evaluating the different fixation options or surgical approaches for tendon repair. This article and accompanying video show the technique and discusses the technical pearls of a latissimus tendon repair using suture button fixation via a single-incision approach.
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Affiliation(s)
- Rami George Alrabaa
- Address correspondence to Rami George Alrabaa, M.D, Department of Orthopedic Surgery, Columbia University Medical Center, 622 West 168th St., PH-11, New York, NY 10032.
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Erickson BJ, Chalmers PN, D'Angelo J, Ma K, Romeo AA. Performance and Return to Sport After Latissimus Dorsi and Teres Major Tears Among Professional Baseball Pitchers. Am J Sports Med 2019; 47:1090-1095. [PMID: 30897340 DOI: 10.1177/0363546519829086] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Latissimus dorsi and teres major (LD/TM) tears are becoming an increasingly common cause of injury and disability among professional baseball pitchers. PURPOSE/HYPOTHESIS To determine performance and return to sport (RTS) among professional baseball pitchers after LD/TM tears treated operatively and nonoperatively and to compare the RTS rate and performance between pitchers who sustained an LD/TM tear and matched controls. The authors hypothesized a high RTS rate among professional baseball pitchers after LD/TM tears, with no significant difference in RTS rate or performance between cases and controls for operative and nonoperative treatment-specifically, in the primary performance outcome variables of WHIP ([walks + hits] / innings pitched), fielding independent pitching, and wins above replacement. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS All professional baseball pitchers who sustained an LD/TM tear between 2011 and 2016 were identified with the Health and Injury Tracking System database of Major League Baseball. Demographic and performance data (before and after injury) were recorded for each player. Performance metrics were then compared between cases and matched controls by operative and nonoperative treatment. RESULTS Overall, 120 pitchers had a documented LD/TM tear; 42 (35%) were major league players. Most players (n = 107, 89.2%) were treated nonoperatively. Time to return to the same level of competition was 170 ± 169 days (mean ± SD) for pitchers treated nonoperatively and 406 ± 146 days for those treated operatively. The RTS rate among players treated nonoperatively and operatively was identical at 75%. Players treated nonoperatively had no change in fielding independent pitching or wins above replacement after injury but had a higher (ie, worse) WHIP after injury ( P = .039); they also performed significantly worse in several secondary performance metrics, including number of games played per year ( P < .001). Players treated operatively had no change in any measured performance metrics after surgery. No difference existed between cases and controls in the primary performance variables. CONCLUSION The majority of LD/TM tears are treated nonoperatively. The RTS rate is 75% for professional baseball pitchers after LD/TM tears treated operatively or nonoperatively. Players treated nonoperatively saw a decline in several performance metrics, while players treated operatively had no significant difference in performance after surgery.
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Affiliation(s)
- Brandon J Erickson
- Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, New York, New York, USA
| | - Peter N Chalmers
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA
| | - John D'Angelo
- Major League Baseball Commissioner's Office, New York, New York, USA
| | - Kevin Ma
- Major League Baseball Commissioner's Office, New York, New York, USA
| | - Anthony A Romeo
- Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, New York, New York, USA
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Abstract
Isolated injury to the latissimus dorsi is rare. Partial tendon tears may be successfully treated nonsurgically. Complete tendon ruptures require surgical repair. Tendon repair can be approached either through an anterior deltopectoral incision with a secondary small posterior axillary incision or through a long posterior axillary incision. Suture anchors can be used to repair the latissimus dorsi to the humeral attachment. Although the literature is limited to single-patient case series, most patients have returned to full athletic activity after surgical repair.
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Performance and return to sport in elite baseball players and recreational athletes following repair of the latissimus dorsi and teres major. J Shoulder Elbow Surg 2017; 26:1948-1954. [PMID: 28689823 DOI: 10.1016/j.jse.2017.05.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/06/2017] [Accepted: 05/08/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND Tears of the latissimus dorsi (LD) and teres major (TM) are rare but disabling injuries in the overhead athlete. METHODS All patients who underwent an LD and/or TM repair between January 1, 2010, and June 6, 2016, with more than 12 months' follow-up were included. Demographic information and postoperative range of motion were recorded. Patients were contacted via phone and answered questions to provide the following: Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow outcome score, American Shoulder and Elbow Surgeons (ASES) shoulder score, and visual analog scale (VAS) score. Performance data for professional athletes were recorded preoperatively and postoperatively and compared by paired t tests. RESULTS Eleven male patients aged 29.9 ± 12.4 years were included; 86% were right hand dominant, 86% underwent surgery on the dominant side, and 73% were pitchers (7 professional and 1 collegiate). The mean time from injury to repair was 389 ± 789 days; 36% of repairs were performed within 6 weeks of injury. At final follow-up, the VAS score was 0.7 ± 1.9, the ASES score was 100 ± 0, and the KJOC score was 93 ± 5. Professional (major and minor league) pitchers had a mean total time participating in professional baseball of 6.6 ± 3.9 years, with 3.9 ± 2.3 years before surgery and 2.7 ± 1.8 years after surgery. Among professional pitchers, the VAS pain score was 0.0 ± 0.0, the ASES score was 100 ± 0, and the KJOC score was 89 ± 2. All professional pitchers returned to the same level of play. No significant differences existed between any preoperative and postoperative performance metrics for pitchers (P > .05). CONCLUSION Repair of LD and TM tears in both professional and recreational athletes produces reliable functional recovery with minimal pain and the ability to return to preoperative athletic activity, even among elite throwing athletes.
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Abstract
Injuries to the latissimus dorsi and teres major muscles, while rare, are debilitating. They are seen in a variety of sports, although disproportionately in the throwing shoulder of baseball pitchers. There have been 25 case reports and 2 case series published on the nonoperative and operative management of these injuries. Latissimus dorsi and teres major muscle anatomy, function, and common injury patterns are well described in these case reports. Also well detailed are the typical patient presentation, physical examination, and imaging findings. Latissimus dorsi tendon injuries are sometimes treated operatively, whereas latissimus dorsi muscle belly or isolated teres major injuries are treated nonoperatively. Nonoperative treatment includes oral anti-inflammatories and shoulder physical therapy. A number of surgical patient positions, approaches, and fixation constructs have been described, although 2 techniques of positioning and surgical approach are used most commonly. Fixation is most often performed with suture anchors. Return-to-play timing, shoulder strength, and healing on magnetic resonance imaging are variable. No standard of care currently exists for the treatment of latissimus dorsi or teres major injuries. If treating a patient with an injury to either muscle, the clinician should be familiar with accumulated experience as reported in the published literature.
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Affiliation(s)
| | - Marc G Lubitz
- Wright State University Boonshoft School of Medicine, Dayton, Ohio, USA
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Latissimus Dorsi and Teres Major Tendon Avulsions in Cricketers: A Case Series and Literature Review. Clin J Sport Med 2017; 27:e24-e28. [PMID: 27309593 DOI: 10.1097/jsm.0000000000000328] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Acute latissimus dorsi tendon injuries are uncommon, having not previously been described in cricketers. The leg spinner's stock ball bowling technique and the fast bowler's back-of-the-hand slow ball, which is used much more widely in T20 cricket, produce a significant eccentric contraction load on the latissimus dorsi muscle. METHODOLOGY A retrospective review of a case series of acute latissimus dorsi tendon injuries in 3 elite cricketers (2 fast bowlers and a leg-spin bowler). We compare the outcomes using patient-rated scales and objective strength testing. Two patients underwent operative repair and had excellent outcomes. One of the nonoperatively managed patients had mild ongoing symptoms at 7 months. DISCUSSION An associated injury to teres major did not affect the outcome of this injury. Operative repair is a viable alternative and may produce better outcomes in cricketers. CONCLUSION The short T20 form of cricket has lead to an increase in the number of back-of-the-hand slow balls, a risk factor for Latissimus injury, whereas leg-spin bowling is another risk.
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Misenhimer J, Kusnezov NA, Pallis MP, Waterman BR. Successful primary repair of chronic latissimus dorsi rupture: a case report and review of the literature. J Shoulder Elbow Surg 2017; 26:e97-e101. [PMID: 28161241 DOI: 10.1016/j.jse.2016.12.072] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 12/18/2016] [Indexed: 02/01/2023]
Affiliation(s)
- Jennifer Misenhimer
- Paul L Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Nicholas A Kusnezov
- Department of Orthopaedic Surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Mark P Pallis
- Department of Orthopaedic Surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Brian R Waterman
- Department of Orthopaedic Surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, El Paso, TX, USA.
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Fysentzou C. Rehabilitation after a grade III latissimus dorsi tear of a soccer player: A case report. J Back Musculoskelet Rehabil 2016; 29:905-916. [PMID: 27104657 DOI: 10.3233/bmr-160699] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Latissimus dorsi, grade III tendon tears are an uncommon injury. There are very few cases reported in the literature, but most importantly, no cases could be found that relate to soccer. OBJECTIVE To present a successful, non-operative rehabilitation program for a professional athlete, after a grade III latissimus dorsi tear. CASE DESCRIPTION A 37 year old healthy, elite professional soccer goalkeeper was injured during a championship game. The athlete fell on his left side with an outstretched and externally rotated upper extremity in order to catch a ball that was going very close to the left pole of his goal-post. After on-field and off-field clinical examinations, the diagnosis was a left latissimus dorsi tendon tear which was later confirmed by MRI as a grade III tear. INTERVENTION During the first two weeks, intervention consisted of anti-inflammatory treatment and light therapeutic exercises. As the pain was subsiding and the strength was returning, the treatment shifted to purely strengthening and functional training. RESULTS Four weeks after the injury, the athlete presented with pain 0/10 in all functional activities and full ROM in both active and passive movements. Before discharge, the athlete underwent a sport specific training program, without any complains, that cleared him to participate in normal training with the rest of the team. Three months after the injury the strength of the player's left shoulder was 5/5 in all movements. CONCLUSION The protocol used yielded an accelerated return to sport (soccer) and function compared with other published research after a grade III latissimus dorsi tendon tear. One year later, the goalkeeper was still playing in the same competitive level without any re-injuries or complains, which means that this treatment protocol withstood the test of time.
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Aldosari SS, McRae SM, MacDonald PB. Surgical reconstruction of chronic latissimus dorsi tear using Achilles tendon allograft. J Shoulder Elbow Surg 2016; 25:e75-9. [PMID: 26927439 DOI: 10.1016/j.jse.2015.11.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 11/12/2015] [Accepted: 11/22/2015] [Indexed: 02/01/2023]
Affiliation(s)
- Sultan S Aldosari
- Department of Orthopedic Surgery, Pan Am Clinic, Winnipeg, Manitoba, Canada
| | | | - Peter B MacDonald
- Department of Orthopedic Surgery, Pan Am Clinic, Winnipeg, Manitoba, Canada; Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
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Friedman MV, Stensby JD, Hillen TJ, Demertzis JL, Keener JD. Traumatic Tear of the Latissimus Dorsi Myotendinous Junction: Case Report of a CrossFit-Related Injury. Sports Health 2015; 7:548-52. [PMID: 26502450 PMCID: PMC4622375 DOI: 10.1177/1941738115595975] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A case of a latissimus dorsi myotendinous junction strain in an avid CrossFit athlete is presented. The patient developed acute onset right axillary burning and swelling and subsequent palpable pop with weakness while performing a “muscle up.” Magnetic resonance imaging examination demonstrated a high-grade tear of the right latissimus dorsi myotendinous junction approximately 9 cm proximal to its intact humeral insertion. There were no other injuries to the adjacent shoulder girdle structures. Isolated strain of the latissimus dorsi myotendinous junction is a very rare injury with a scarcity of information available regarding its imaging appearance and preferred treatment. This patient was treated conservatively and was able to resume active CrossFit training within 3 months. At 6 months postinjury, he had only a mild residual functional deficit compared with his preinjury level.
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Affiliation(s)
- Michael V Friedman
- Mallinckrodt Institute of Radiology, Washington University School of Medicine and Barnes-Jewish Hospital, St. Louis, Missouri
| | - J Derek Stensby
- Mallinckrodt Institute of Radiology, Washington University School of Medicine and Barnes-Jewish Hospital, St. Louis, Missouri
| | - Travis J Hillen
- Mallinckrodt Institute of Radiology, Washington University School of Medicine and Barnes-Jewish Hospital, St. Louis, Missouri
| | - Jennifer L Demertzis
- Mallinckrodt Institute of Radiology, Washington University School of Medicine and Barnes-Jewish Hospital, St. Louis, Missouri
| | - Jay D Keener
- Department of Orthopedic Surgery, Washington University School of Medicine and Barnes-Jewish Hospital, St. Louis, Missouri
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Boutin RD, Fritz RC. MRI of Musculotendinous Injuries—What’s New? Part II: Strain Injuries. CURRENT RADIOLOGY REPORTS 2015. [DOI: 10.1007/s40134-015-0109-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Çelebi MM, Ergen E, Üstüner E. Acute traumatic tear of latissimus dorsi muscle in an elite track athlete. Clin Pract 2013; 3:e15. [PMID: 24765503 PMCID: PMC3981267 DOI: 10.4081/cp.2013.e15] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 03/05/2013] [Accepted: 03/12/2013] [Indexed: 11/23/2022] Open
Abstract
Soft tissue injuries constitute 30-50% of all sports related injuries; however, injury to the latissimus dorsi muscle is quite rare with only a few cases reported in the literature. Herein, we describe an acute traumatic tear of the latissimus dorsi muscle in an elite track athlete, which has not been reported in the track and field sports before. The injury was caused by forceful resisted arm adduction that took place at hurdling and starting from the block. A pseudotumor appearance in the axillary region was misdiagnosed as a mass. The diagnosis was made by ultrasound alone and the patient was managed conservatively.
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Affiliation(s)
| | | | - Evren Üstüner
- Ankara University School of Medicine, Sports Medicine Department, Cebeci Hospital, Ankara, Turkey
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Ellman MB, Yanke A, Juhan T, Verma NN, Nicholson GP, Bush-Joseph C, Bach BR, Romeo AA. Open repair of an acute latissimus tendon avulsion in a Major League Baseball pitcher. J Shoulder Elbow Surg 2013; 22:e19-23. [PMID: 23706873 DOI: 10.1016/j.jse.2013.03.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 03/11/2013] [Accepted: 03/17/2013] [Indexed: 02/01/2023]
Affiliation(s)
- Michael B Ellman
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
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Garrigues GE, Lazarus MD. Operative treatment of isolated teres major ruptures. J Shoulder Elbow Surg 2012; 21:e6-11. [PMID: 22217640 DOI: 10.1016/j.jse.2011.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Accepted: 10/10/2011] [Indexed: 02/01/2023]
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Surgical Repair of a Subacute Latissimus Dorsi Tendon Rupture. TECHNIQUES IN SHOULDER AND ELBOW SURGERY 2011. [DOI: 10.1097/bte.0b013e31822dc8db] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cox EM, McKay SD, Wolf BR. Subacute repair of latissimus dorsi tendon avulsion in the recreational athlete: two-year outcomes of 2 cases. J Shoulder Elbow Surg 2010; 19:e16-9. [PMID: 20655768 DOI: 10.1016/j.jse.2010.03.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Revised: 03/19/2010] [Accepted: 03/28/2010] [Indexed: 02/01/2023]
Affiliation(s)
- Efrem M Cox
- University of Iowa Carver College of Medicine, Iowa City, IA, USA
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Magnetic resonance imaging appearance of partial latissimus dorsi muscle tendon tear. Skeletal Radiol 2009; 38:1107-10. [PMID: 19449000 DOI: 10.1007/s00256-009-0717-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Revised: 04/29/2009] [Accepted: 05/04/2009] [Indexed: 02/02/2023]
Abstract
There is still a paucity of information about the clinical presentation, treatment and imaging findings of latissimus muscle tears. Only one study has specifically described the magnetic resonance imaging (MRI) features of latissimus tendon tears. We describe a case of a high-grade tear in the latissimus muscle tendon in an active water skier with no significant prior medical history. MRI demonstrated at least a 50% tear of the latissimus tendon, manifesting as increased signal intensity on T2-weighted sequences and surrounding edema, as well as a diminutive tendon at the humeral insertion.
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Schickendantz MS, Kaar SG, Meister K, Lund P, Beverley L. Latissimus dorsi and teres major tears in professional baseball pitchers: a case series. Am J Sports Med 2009; 37:2016-20. [PMID: 19541846 DOI: 10.1177/0363546509335198] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Latissimus dorsi and teres major tendon tears are uncommon injuries. Only a few case reports exist, mainly in high-level athletes. PURPOSE To describe a series of latissimus dorsi and teres major tendon tears in professional baseball pitchers. STUDY DESIGN Case series; Level of evidence, 4. METHODS Injury data from 3 Major League Baseball clubs were collected over a total of 10 seasons. Any baseball player who sustained an injury to either the latissimus dorsi or teres major identified on magnetic resonance imaging (MRI) was included. All injured players were treated nonoperatively with a goal of returning to full velocity throwing at 3 months from the time of injury. RESULTS Ten players sustained injuries to the latissimus dorsi and/or the teres major during pitching. The MRI findings documented 5 isolated latissimus dorsi tears, 4 isolated teres major tears, and 1 combined injury. All athletes returned to pitching, and all but 1 player returned to baseball at the same level of competition in the same season. Nine of 10 players returned at 3 months from the time of their injury. One recurrence was seen 6 months after returning to throwing; however, this healed with further nonoperative treatment, and the player returned to competition at the same level 6 weeks later. One player had continued shoulder symptoms and retired at the end of the season. CONCLUSION Although uncommon, tears of the latissimus dorsi and teres major occur in professional baseball players. Acute injuries are demonstrated on standard shoulder MRI, although larger field-of-view images are required to accurately assess the injury. Most heal successfully with nonoperative treatment, and most players are able to return to the same level of competition in 3 months.
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Hapa O, Wijdicks CA, LaPrade RF, Braman JP. Out of the ring and into a sling: acute latissimus dorsi avulsion in a professional wrestler: a case report and review of the literature. Knee Surg Sports Traumatol Arthrosc 2008; 16:1146-50. [PMID: 18810389 DOI: 10.1007/s00167-008-0625-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Accepted: 09/04/2008] [Indexed: 11/29/2022]
Abstract
We present a 29-year-old professional wrestler who sustained a traumatic latissimus dorsi tendon rupture from its humeral insertion. To our knowledge, this report is the first to describe the use of two small anterior axillary incisions to repair a traumatic avulsion of the latissimus dorsi. Our new surgical approach is an alternative treatment for highly competitive, muscular athletes, while taking the associated nerves and cosmetic appearance into consideration.
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Affiliation(s)
- Onur Hapa
- Department of Orthopaedic Surgery, Division of Sports Medicine, Biomechanics Laboratory, University of Minnesota, 2450 Riverside Avenue South, R200, Minneapolis, MN 55454, USA
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Affiliation(s)
- Jason W Levine
- Mississippi Sports Medicine and Orthopaedic Center, Jackson, Mississippi, USA
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Hiemstra LA, Butterwick D, Cooke M, Walker REA. Surgical management of latissimus dorsi rupture in a steer wrestler. Clin J Sport Med 2007; 17:316-8. [PMID: 17620788 DOI: 10.1097/jsm.0b013e318032128b] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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