We had satisfactory results with infrasupinatus muscle transfer for massive rotator cuff tears with suprasupinatus muscle atrophy reported by Patte.
12 patients received infrasupinatus muscle transfer. There were 8 males and 4 females with an average age of 70 years old (55 to 81 years old). The patients were affected on the right side (the dominant side) except 1 case. The etiology of rotator cuff tear was fell down in 6 and unknown in 6. All patients had rest and motion pain, contracture of shoulder was not observed and active-ROM (a-ROM) was under 90 degrees in 7 cases. The follow-up period averaged 15 months (range, 6 to 26 months). A brace with a 30-degree-abduction brace was applied in all patients after surgery, then they started passive ROM exercises from the day after surgery. Active ROM exercises without a brace was started from six to 8 weeks after surgery. All patients were evaluated with electromyograph ( EMG ) after surgery. Shoulder pain disappeared in 6 patients, and improved in 6 patients. The average active ROM improved from flexion 88°/ abduction 93° to 155°/161°, the suprasupinatus test became negative after surgery. The average JOA score improved from 52.3 preoperatively to 91.0 postoperatively. The amplitude and interference pattern in EMG still decreased in 10 patients slightly and were normal in 2 patients 24 four months after surgery. Infrasupinatus muscle transfer is an effective method for massive irreparable rotator cuff tears with suprasupinatus muscle atrophy and did not produce to suprascapular nerve palsy.
