Coracohumeral Ligament Sectioning in Teres Major versus Latissimus Dorsi Tendon Transfer in Brachial Plexus Birth Palsy

Background The latissimus dorsi tendon transfer (LDTT) to the supraspinatus tendon is a common procedure for restoring shoulder abduction and external rotation in upper root brachial plexus lesions. However, its association with scapular retraction often limits shoulder abduction. Methods This retro...

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Authors: Gutierrez-Pereira, J, Garcia-Lopez, A
Format: article
Status:Published version
Publication Date:2025
Country:España
Institution:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repository:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:dnet:isabial_____::9d8e9aa363d657a3f2e38cecef65e53f
Online Access:https://isabial.portalinvestigacion.com/publicaciones12637
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2618-3151
Access Level:Open access
Keyword:coracohumeral ligament
latissimus dorsi
brachial plexus birth injury
tendon transfer
teres major
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spelling Coracohumeral Ligament Sectioning in Teres Major versus Latissimus Dorsi Tendon Transfer in Brachial Plexus Birth PalsyGutierrez-Pereira, JGarcia-Lopez, Acoracohumeral ligamentlatissimus dorsibrachial plexus birth injurytendon transferteres majorBackground The latissimus dorsi tendon transfer (LDTT) to the supraspinatus tendon is a common procedure for restoring shoulder abduction and external rotation in upper root brachial plexus lesions. However, its association with scapular retraction often limits shoulder abduction. Methods This retrospective study compared the functional outcomes of teres major tendon transfer (TMTT) combined with anterior coracohumeral ligament release (CHLR) versus LDTT. Patients who underwent surgery at our center between January 2012 and December 2022 were included, with a mean follow-up of 38 months. Outcomes were assessed using a range of motion and the Mallet scale. Results A total of 40 patients were included, with 20 undergoing TMTT with CHLR and 20 undergoing LDTT. The overall mean age was 3.9 years (range: 2.7-4.8), with mean ages of 3.4 years (range: 2.2-5.2) in the LDTT group and 4.1 years (range: 2.8-5.2) in the TMTT with the CHLR group. The TMTT with CHLR group achieved mean gains of +77 degrees in active abduction, +44 degrees in active external rotation, and +46 degrees in passive external rotation. In comparison, the LDTT group demonstrated gains of +46, +27, and +24 degrees, respectively, for the same parameters. Conclusion TMTT combined with anterior CHLR significantly improves shoulder abduction and external rotation in patients with Brachial plexus birth injury, particularly those with internal rotation contractures. This technique offers superior functional outcomes compared to LDTT, suggesting a more effective therapeutic alternative.Level of Evidence IV, retrospective comparative study.THIEME MEDICAL PUBL INC2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones12637https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2618-3151Journal of Brachial Plexus and Peripheral Nerve InjuryISSN: 17497221reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:dnet:isabial_____::9d8e9aa363d657a3f2e38cecef65e53f2026-06-12T10:20:37Z
dc.title.none.fl_str_mv Coracohumeral Ligament Sectioning in Teres Major versus Latissimus Dorsi Tendon Transfer in Brachial Plexus Birth Palsy
title Coracohumeral Ligament Sectioning in Teres Major versus Latissimus Dorsi Tendon Transfer in Brachial Plexus Birth Palsy
spellingShingle Coracohumeral Ligament Sectioning in Teres Major versus Latissimus Dorsi Tendon Transfer in Brachial Plexus Birth Palsy
Gutierrez-Pereira, J
coracohumeral ligament
latissimus dorsi
brachial plexus birth injury
tendon transfer
teres major
title_short Coracohumeral Ligament Sectioning in Teres Major versus Latissimus Dorsi Tendon Transfer in Brachial Plexus Birth Palsy
title_full Coracohumeral Ligament Sectioning in Teres Major versus Latissimus Dorsi Tendon Transfer in Brachial Plexus Birth Palsy
title_fullStr Coracohumeral Ligament Sectioning in Teres Major versus Latissimus Dorsi Tendon Transfer in Brachial Plexus Birth Palsy
title_full_unstemmed Coracohumeral Ligament Sectioning in Teres Major versus Latissimus Dorsi Tendon Transfer in Brachial Plexus Birth Palsy
title_sort Coracohumeral Ligament Sectioning in Teres Major versus Latissimus Dorsi Tendon Transfer in Brachial Plexus Birth Palsy
dc.creator.none.fl_str_mv Gutierrez-Pereira, J
Garcia-Lopez, A
author Gutierrez-Pereira, J
author_facet Gutierrez-Pereira, J
Garcia-Lopez, A
author_role author
author2 Garcia-Lopez, A
author2_role author
dc.subject.none.fl_str_mv coracohumeral ligament
latissimus dorsi
brachial plexus birth injury
tendon transfer
teres major
topic coracohumeral ligament
latissimus dorsi
brachial plexus birth injury
tendon transfer
teres major
description Background The latissimus dorsi tendon transfer (LDTT) to the supraspinatus tendon is a common procedure for restoring shoulder abduction and external rotation in upper root brachial plexus lesions. However, its association with scapular retraction often limits shoulder abduction. Methods This retrospective study compared the functional outcomes of teres major tendon transfer (TMTT) combined with anterior coracohumeral ligament release (CHLR) versus LDTT. Patients who underwent surgery at our center between January 2012 and December 2022 were included, with a mean follow-up of 38 months. Outcomes were assessed using a range of motion and the Mallet scale. Results A total of 40 patients were included, with 20 undergoing TMTT with CHLR and 20 undergoing LDTT. The overall mean age was 3.9 years (range: 2.7-4.8), with mean ages of 3.4 years (range: 2.2-5.2) in the LDTT group and 4.1 years (range: 2.8-5.2) in the TMTT with the CHLR group. The TMTT with CHLR group achieved mean gains of +77 degrees in active abduction, +44 degrees in active external rotation, and +46 degrees in passive external rotation. In comparison, the LDTT group demonstrated gains of +46, +27, and +24 degrees, respectively, for the same parameters. Conclusion TMTT combined with anterior CHLR significantly improves shoulder abduction and external rotation in patients with Brachial plexus birth injury, particularly those with internal rotation contractures. This technique offers superior functional outcomes compared to LDTT, suggesting a more effective therapeutic alternative.Level of Evidence IV, retrospective comparative study.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones12637
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2618-3151
url https://isabial.portalinvestigacion.com/publicaciones12637
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/a-2618-3151
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv THIEME MEDICAL PUBL INC
publisher.none.fl_str_mv THIEME MEDICAL PUBL INC
dc.source.none.fl_str_mv Journal of Brachial Plexus and Peripheral Nerve Injury
ISSN: 17497221
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.812455

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