Fig 5.

The patient is positioned in the lateral decubitus position and the right latissimus tendon has been exposed, mobilized, and controlled with suture. Next, the footprint of the latissimus tendon on the humerus is exposed between the triceps and pectoralis major. One retractor is placed anteriorly to retract and protect the pectoralis major, biceps, and radial nerve. A second retractor is placed posteriorly to retract the triceps and branches of the posterior brachial cutaneous nerve and a third retractor is placed at the apex of the wound to aid in visualization. (A) Any remaining soft tissue on the footprint is debrided and the bone is abraded with a curette. Once adequate exposure of the footprint is obtained, 2 unicortical drill holes are made with the appropriate drill size, one proximal and one distal about 1 to 2 cm apart (B), to accommodate passage of 2 suture buttons unicortically. (H, humerus; LT, latissimus tendon; T, triceps.)