Arthroscopic humeral head interference screw fixation for latissimus dorsi transfer in massive and irreparable posterosuperior cuff tear

Thirty percent of the patients attending shoulder specialty centers for surgery present with the challenge of massive and irreparable rotator cuff tears (1). Some of these patients have already been operated by open or arthroscopic technique, even before the age of 50 years. Gerber et al. (2) are the first to publish flap surgery for the treatment of these massive and irreparable cuffs. They cautioned about the indications of this LD flap when posterosuperior cuff tears were associated with subscapularis tears as the results were guarded and disappointing. Other authors (3–5) also confirmed poor results in case of subscapularis tears, deltoid anterior deficit, and as salvage procedure, where no solution exists today.