Table 2.

Pearls and Potential Pitfalls of Single-Incision Latissimus Tendon Repair With Suture Button Fixation in the Lateral Decubitus Position

Pearls

•The humeral aspect of the incision to expose the humeral footprint remains relatively constant while the incision along the posterior chest wall can be extended to retrieve a retracted tendon. •A seroma cavity can be encountered as dissection proceeds closer to the latissimus tendon stump. •The humerus is maximally internally rotated to adequately expose the intertubercular groove and the footprint of the latissimus tendon during this approach. •Sutures used to repair the tendon are cut short to prevent irritation. Arthroscopic knot pushers and arthroscopic suture cutters can be utilized to facilitate knot tension deep in the wound as well as a short tail.

Potential pitfalls

•Pertinent neuroanatomy should be thoroughly reviewed as the axillary, radial, and posterior brachial cutaneous nerves are at risk during this procedure. The axillary nerve is expected to be just deep and proximal to the latissimus tendon in the floor of the exposure. •The latissimus tendon externally rotates 90° before inserting onto the humerus and this must be kept in mind for the tendon to be repaired in proper orientation back to its footprint. •Excessive suturing of the dermal and subcuticular layers should be avoided as that area can be sensitive.