Latissimus Dorsi Transfer and Anterior Capsular Reconstruction for Subscapularis and Pectoralis Major Tears

Case: A 48-year-old right-hand dominant man presented with a 3-year history of right pectoralis major (PM) and subscapularis tears and failed arthroscopic subscapularis repair 1 year prior. He endured pain, weakness in internal rotation, and limited motion. Owing to marked anterior soft tissue deficiency, he underwent open chronic subscapularis reconstruction with latissimus dorsi (LD) tendon transfer, anterior capsular reconstruction (ACR), and PM reconstruction with Achilles tendon allograft. At 1 year postoperative, he reported no pain, good functional improvement, and excellent satisfaction. Conclusion: LD tendon transfer and ACR are useful augments in repairing chronic subscapularis tears with anterior soft tissue insufficiency. Level of evidence: V.