The Orthobiologic Institute (TOBI) Faculty Brian J. Cole Publishes New Study in the Journal of Shoulder and Elbow Surgery
Brian J. Cole, The Orthobiologic Institute (TOBI) Faculty, recently published a new article in the Journal of Shoulder and Elbow Surgery titled “A comprehensive analysis of pectoralis major transfer for long thoracic nerve palsy.” The study was done to determine superiority outcomes in treatment methods of long thoracic nerve palsy with pectoralis major transfer. More specifically, it compared direct transfer of the pectoralis to the scapula and indirect transfer with an interpositional graft.
The study was done in 3 tiers to form a comprehensive evaluation. The first-tier included a survey of the membership of the American Shoulder and Elbow Surgeons (ASES) to cast a Level V consensus. The second-tier consisted of a systematic review used to identify studies evaluating direct and indirect transfer of the pectoralis major tendon to formulate a Level IV consensus. The last tier was a retrospective review to construct Level III evidence.
The results of the first-tier of the study revealed that surgeons were evenly divided between whole and split tendon transfers, direct and indirect transfers, and types of grafts. Indirect transfer was preferred by more experienced surgeons. The second-tier included an analysis of 10 level IV studies, which included 131 cases. It showed that patients who had indirect transfers were significantly more likely to develop recurrent winging in addition to having lower active forward elevation and ASES scores. The third-tier included a retrospective review of 24 patients, which included 14 indirect transfers and 10 direct transfers. There were no significant differences in terms of scapular winging recurrence, range of motion, or ASES scores.The study concluded that there is no functional difference between the methods in which pectoralis major transfers are done for long thoracic nerve palsy.
Learn more from Dr. Brian Cole at the 6th Annual TOBI: The Orthobiologic Institute PRP & Regenerative Medicine Symposium with Cadaver Lab June 12-14, 2015 in Las Vegas, www.prpseminar.com
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