Global Advanced Research Journal of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
July 2018, Vol. 7(6), pp. 127-131
Copyright © 2018 Global Advanced Research Journals

 

Full Length Research Article

The use of pectoralis major tendon transfer in the treatment of irreparable subscapularis tears in the adult: a meta-analysis of the last 5 years

Angelo Ton1*, Francisco Jorge Daher Carneiro Neto1, Ana Paula Teixeira Gradim2, Gaudio Germano Souza Sena2, Anderson De Nadai1 and Bernardo Barcellos Terra1

1Orthopedic and Traumatology Service of Vitoria Apart Hospital –Serra – Brazil
2Orthopedic and Traumatology Service of Santa Casa de Misericórdia Hospital – Vitoria - Brazil

*Corresponding Author E-mail: lyne_msv@hotmail.com; Phone number: +5527981347065

Accepted 19 July, 2018

Abstract

The musculotendinous forces must be balanced in all planes around the glenohumeral joint in order to guarantee the stability and functionality of the shoulder. The transfer of the pectoralis major tendon is described as a salvage procedure in this situation, proving to be a reasonable but little explored alternative in case of failure to heal the rotator cuff with improvement of pain and functionality of the shoulder, partially restoring the subscapular function, ensuring balance in the coupling process and allowing the deltoid to effectively contribute to shoulder elevation. This meta-analysis study objectives to evaluate the efficacy of transfering the pectoralis major tendon as a treatment of irreparable subscapularis tears. Concerning the parametric data analyzed in all of the studies included, we can observe the distribution of the Constant score recovery average prior to the pectoralis major transfer and after the procedure. The reduced samples, absence of the control group in all included studies prevented the determination of the actual efficacy and/or superiority of the pectoralis major transfer over the other methods used in the treatment of this unique pattern of injury. Therefore, greater efforts are needed in the research and application of randomized controlled clinical trials that can define the most effective therapeutic measures in the treatment of this pathology.

Keywords: Pectoralis Major, Rotator Cuff, Subscapularis, Anterosuperior Rotator

 

References

Elhassan BT, et al (2008). Transfer of pectoralis major for the treatment of irreparable tears of subscapularis: does it work? British Editorial Society of Bone and Joint Surgery. 90-B;1059-1065.

Elhassan BT, et al (2017). Management of failed rotator cuff repair in young patients. J. Am. Academ. Ortho. Surg. 25(11)261-271.

Galatz LM, Connor PM, Calfee RP, Hsu JC, Yamaguchi K (2003). Pectoralis major transfer for anteriorsuperior subluxation in massive rotator cuff insufficiency. J. Shoulder Elbow Surg. 12:1-5.

Gerber C, Hersche O (1997). Tendon transfers for the treatment of irreparable rotator cuff defects. Orthop. Clin.  North Am. 28:195-203.

Gerber C, Hersche O, Farron A (1996). Isolated rupture of the subscapularis tendon. J. Bone Joint Surg. Am. 78-A:1015-23.

Graviilidis I, et al (2010). Pectoralis major transfer for the treatment of irreparable anterosuperior rotator cuff tears. International Orthopaedics. 34:689–694.

McMahon PJ, Debski RE, Thompson WO, et al (1995). Shoulder muscle forces and tendon excursions during glenohumeral abduction in the scapular plane. J. Shoulder Elbow Surg. Am. 4:199-208.

Moroder P, et al (2017). Long-term outcome after pectoralis major transfer for irreparable anterosuperior rotator cuff tears. J. Bone Joint Surg. Am. 99:239-245.

Nelson GN (2014). Pectoralis major tendon transfer for irreparable subscapularis tears. J. Shoulder Elbow Surg.  Pp. 1-10.

Rokito AS, Cumo F, Gallagher MA, Zuckerman JD (1999). Long-term functional outcome of repair of large and massive chronic tears of the rotator cuff. J. Bone Joint Surg. Am. 81-A:991-997.

Shin JJ, et al (2016). Pectoralis major transfer for treatment of irreparable subscapularis tear: a systematic review. Knee Surg Sports Traumatol Arthrosc . 24(6):1951-60

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