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Latissimus Dorsi Rupture

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Topic updated on 09/04/13 7:33pm
Introduction
  • Rare condition but has been reported as a cause of pain in the thrower’s shoulder
  • Epidemiology
    • very rare condition
  • Pathophysiology
    • mechanism
      • felt to be eccentric overload during the follow-through of the throwing motion
Anatomy
  • Latissimus dorsi muscle
Presentation
  • Physical exam
    • local tenderness and deformity over latissimus dorsi muscles
    • pain with shoulder adduction and internal rotation
Imaging
  • MRI
    • shows increased T2 signal and retraction of latissimus dorsi muscle
Treatment
  • Nonoperative
    • short period of rest followed by PT
      • indications
        • allow resumption of activities in low demand patients
      • technique
        • physical therapy goals are to restore shoulder motion and strength
        • throwing can be allowed
          • after full, pain-free motion and good strength
          • balance of the rotator cuff and scapular rotator muscles
  • Operative
    • primary repair vs reconstruction
      • indications
        • for high demand athletes (currently there are no defined indications for surgical repair)
      • technique
        • early primary repair is favored to prevent retraction and scarring

 

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