Traumatic Tear of the Latissimus Dorsi Tendon in a CrossFit Athlete: Surgical Management

INTRODUCTION: Traumatic tears of the latissimus dorsi tendon (LDT) are a rare sports injury that may occur during exercises involving horizontal and vertical pulling. A standardized treatment algorithm for this injury does not yet exist. CASE REPORT: A 30-year old male CrossFit Athlete experienced sudden unbearable pain in his right posterior shoulder during a bar muscle-up exercise. The contour of his right posterior shoulder had changed immediately, and the patient could not do any more exercises involving his right shoulder. BMagnet resonance imaging (MRI) revealed an isolated tear of the LDT. The repair of the tendon was performed using a posterior approach in the lateral decubitus position. After arming the tendon with non-absorbable sutures it was reinserted onto the crest of the lesser tuberosity of the proximal humerus with two monocortical suture buttons. Postoperatively, the patient was immobilized with an abduction pillow for 6 weeks. After 9 months he reported a 90% function of his shoulder. MRI showed complete anatomical reinsertion of the LDT. The patient was able to master 15 pull-ups in a row. CONCLUSIONS: Surgical repair of the LDT may achieve good functional results as well as an acceptable recovery period.