Repair of an Acute Latissimus Dorsi Tendon Rupture Using Bicortical Button Fixation

Document Type

Journal Article

Publication Date

1-1-2020

Journal

Techniques in Shoulder and Elbow Surgery

Volume

21

Issue

3

DOI

10.1097/BTE.0000000000000195

Keywords

acute tendon rupture; bicortical button; latissimus dorsi; surgical repair

Abstract

© 2020 Lippincott Williams and Wilkins. All rights reserved. Acute latissimus dorsi tendon rupture is a rare injury, occurring nearly exclusively in athletes engaging in overhead motions. Given this patient population, return to elite function is a goal of treatment, often requiring surgery. When planning surgery, one finds a lack of sufficient evidence to recommend a specific fixation technique. We report a case of acute rupture of the latissimus dorsi in a competitive gymnast. Initial magnetic resonance imaging confirmed the injury and showed that the tendon had retracted 6 cm. Primary repair using bicortical button fixation, a novel fixation technique, was performed. The patient successfully returned to competition and reported personal best scores on high bar and parallel bars. Cadaveric studies comparing cortical buttons to sutures and suture anchors for tendon reattachment found cortical buttons to have higher loads to failure. Overall, this suggests the technique described here may provide superior outcomes for a patient population who will stress the repair at elite levels.Level of Evidence: Level V.

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