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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 9/2013

01-09-2013 | Shoulder

Pectoralis major transfer for subscapular deficiency: anatomical study of the relationship between the transferred muscle and the musculocutaneous nerve

Authors: Miguel Á. Ruiz-Ibán, Jorge A. Murillo-González, Jorge Díaz-Heredia, Jose Luis Ávila-Lafuente, Ricardo Cuéllar

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 9/2013

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Abstract

Purpose

Pectoralis major transfer is indicated for irreparable subscapularis tendon tears. One surgical option is transferring the sternal part of the pectoralis major to the humeral insertion of the subscapularis under the conjoined tendon of the coracobrachialis and biceps muscles. The purpose of this study is to define the anatomical relationship between the transferred tendon and the musculocutaneous nerve.

Methods

In 52 cadaveric fresh-frozen shoulders, the relevant structures were dissected and a pectoralis major transfer was performed. The relationship between the transferred tendon, the musculocutaneous nerve branches distally and the coracoid process proximally was examined. Measurements were taken at the conjoined tendon level.

Results

The distance between the coracoid process and the most proximal musculocutaneous nerve branch was 54.2 ± 33.2 mm. In 25 cases (48 %), the transferred tendon passed freely between both structures. In 16 cases (31 %), there was contact distally with the musculocutaneous nerve. In 11 cases (21 %), there was contact both proximally with the coracoid process and distally with the musculocutaneous nerve, making a safe transfer impossible.

Conclusions

When performing a pectoralis major transfer, it is essential to identify the musculocutaneous nerve and its branches. In some cases, a subcoracobicipital transfer may not be feasible and a more superficial transfer should be considered.
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Metadata
Title
Pectoralis major transfer for subscapular deficiency: anatomical study of the relationship between the transferred muscle and the musculocutaneous nerve
Authors
Miguel Á. Ruiz-Ibán
Jorge A. Murillo-González
Jorge Díaz-Heredia
Jose Luis Ávila-Lafuente
Ricardo Cuéllar
Publication date
01-09-2013
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 9/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2432-0

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