Research ArticleOriginal Article
Open Access

The clinical results of lower trapezius tendon transfer with the peroneus longus allograft augmentation combined with interpositional repair with fascia lata in massive irreparable rotator cuff tears

Muhammet Bozoğlan, Murat Danışman, Tuğcan Demir, Halil Karaca and Cem Zeki Esenyel
Saudi Medical Journal February 2023, 44 (2) 164-170; DOI: https://doi.org/10.15537/smj.2023.44.2.20220721

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    - Measurement method of acromio-humeral distance preoperatively (a) and postoperatively (b). Magnetic resonance views preoperative (c) and postoperative (d).

  • Figure 2
    Figure 2

    - Stages of the surgical procedure (a) Right shoulder of the patient with lateral decubitus position and landmarks. (b) The appearance of the subacromial space and humeral head after the acromioplasty. (d) Insertion area of the lower trapezius tendon to the scapula after the dissection of fascia. (c) Detaching lower trapezius tendon from the spine of scapula. (e) The path that was created between deltoid and infraspinatus (f) after fixing the allograft to the tuberculum majus the black arrow shows the gap on humeral head, (g) after suturing the allograft to the lower trapezius tendon, (h) measuring the gap on the humeral head.

  • Figure 3
    Figure 3

    - Interpositional repair of the gap. (a) Shematic drawing of the gap on humeral head in patients with massive cuff tear after lower trapezius tendon transfer (b) and covering of the gap with fascia lata autograft. (c) The closed gap was shown with the arrow.

Tables

  • Table 1

    - Preoperative (preop) descriptive values of total UCLA scores, Constant Murley scores,VAS pain scores, acromiohumeral distance and active range of motions of shoulder (N=16).

    Evaluated parametersMinimumMaximumMeanSD
    Total UCLA score preop3,0010,005.902.13
    Total Constant Murley score preop15,0045,0024.009.43
    VAS pain score preop4,008,006.101.10
    Acromiohumeral distance preop3,426,234.640.85
    Forward flexion preop60,00140,00109.0024.70
    Abduction preop40,0090,0060.0016.33
    External rotation preop-20,0030.0012.0016.87

    UCLA: University of California Los Angeles VAS: Visual Analog Scale, SD: standard deviation,

    • Table 2

      - Prostoperative (postop) descriptive values of total UCLA scores, Constant Murley scores,VAS pain scores, acromiohumeral distance and active range of motions of shoulder.

      Evaluated parametersMinimumMaximumMeanSD
      Total UCLA score postop15,0030,0022.705.29
      Total Constant_Murley score postop19,0068,0050.2014.28
      VAS pain score postop1,005,002.401.35
      Acromiohumeral distance postop5,258,216.580.84
      Forward flexion postop90,00170,00144.0022.21
      Abduction postop110,00170,00135.0016.33
      External rotation postop0,0045,0035.0014.34

      UCLA: University of California Los Angeles VAS: Visual Analog Scale, SD: standard deviation

      • Table 3

        - Comparison of preoperative and postoperative values (Wilcoxon signed-rank test).

        Evaluated parametersPreoperativePostoperativeZP
        MeanSDMeanSD
        Total UCLA score5.92.122.75.3-2,810.005
        Total Constant Murley score24.09.450.214.3-2,670.008
        VAS pain score6.11.12.41.4-2,690.007
        Acromiohumeral distance4.60.96.60.8-2,810.005
        Forward flexion109.024.7144.022.2-2,820.005
        Abduction60.016.3135.016.3-2,810.005
        External rotation12.016.935.014.3-2,830.005

        UCLA: University of California Los Angeles, SD: standard deviation

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