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Since its inauguration by Gerber in 1988, the latissimus dorsi transfer has become an established surgical option for non-reconstructable, massive posterosuperior rotator cuff tears. We describe 26 consecutive patients, all of whom underwent a latissimus dorsi transfer using a modified single incision mini-invasive Herzberg transfer. The primary focus of this paper was to compare the applied clinical results of this new technique with the published results of the Gerber technique. Following transfer of the latissimus dorsi to restore external rotation, 26 patients were evaluated. The mean age was 60 +/- 18 years. The patients were examined after surgery at an average of 24 months (range: 12-41). The unweighted Constant score rose from 20 (range: 13-34) to 56 (range: 63-81). The acromiohumeral distance remained statistically unchanged from an initial value of 4.7 mm (1-9 mm) to a postoperative value of 4.8 (2-11 mm). In the Hamada classification the level of rotator cuff defect arthropathy increased from 1.7 (1-3) to 1.8 (1-3). On the basis of its low morbidity rate, the latissimus dorsi transfer in Herzberg's modified technique is a sensible alternative to the technique initially described by Gerber, especially when the initial situation exhibits pre-existing weakness of the deltoid muscle.

The diagnostic and treatment of a closed avulsion of the flexor digitorum profundus muscle at its insertion of the little finger is presented. This happened as a 41-year-old woman wanted to hold a dog lead in her left hand and suddenly the dog started to run. In the literature the flexor digitorum profundus (FDP) and flexor pollicis longus (FPL) tendons were found to be more frequently ruptured than the flexor digitorum superficialis tendon. Closed ruptures of the FDP have been rarely reported. In the case described here there was no torn fragment at the distal end of the FDP tendon and the bone structure of the phalanx distales was intact. The operative treatment, postoperative care and clinical course are presented.