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Latissimus dorsi tendon transfer to restore shoulder abduction in patients with deltoid paralysis: A novel technique

Shoulder abduction is an essential movement for placement of the hand in space and thus for upper limb function. The objective of this study was to introduce and test the effectiveness of a new technique of latissimus dorsi tendon transfer to deltoid insertion to restore shoulder abduction. We prospectively included 10 male patients with a lost deltoid function. Their mean age was 34.6 years (range, 25−46). We describe a new technique to compensate for the loss of the deltoid function using a latissimus dorsi tendon transfer augmented with a semitendinosus tendon graft. The tendon graft is passed over the acromion and attached to the anatomical deltoid insertion. Postoperatively, a shoulder spica in 90° abduction was used for six weeks followed by physiotherapy. Patients were followed up for a mean of 25.4 months (range, 12–48). The mean range of active shoulder abduction rose to 110° (range, 90–140°) with a mean gain of 83° of abduction. This procedure can be a useful technique for restoration of a significant range and strength of active shoulder abduction.