The latissimus dorsi muscle is one of the strongest and largest muscles in the back. This muscle is used when lifting the arms up to the side and the extension of the shoulder. A latissimus tear is rare, but most commonly found in competitive athletes participating in activities such as water skiing, pitching in baseball, volleyball, gymnastics, or rock climbing. In non-competitive athletes, a non-operative route is likely to produce a satisfactory outcome. For competitive athletes, surgical repair may be best for a successful return.
The latissimus dorsi repair is done by making an incision in the back of arm, near the armpit. The ruptured tendon is then located, and sutures are placed in the end of the torn tendon. Those sutures are then used to pull the tendon back up to the arm bone where the tendon ruptured. Small metallic anchors, called buttons, are then used to fix the tendon to the bone.
After surgery, the patient maintains in a brace for six weeks. Elbow, wrist and hand motions begin right after surgery. Physical therapy begins two weeks following surgery with passive shoulder range of motion exercises. Active range of motion begins six weeks after surgery. Return to light recreational activities at 3-4 months after surgery, with anticipated return to sports 6-8 months after surgery.