Latissimus dorsi tendon transfers for irreparable rotator cuff tears after inferior glenohumeral dislocation: a rare case report

<h2>Abstract:</h2> Bilateral inferior shoulder dislocation is an extremely rare condition, typically reported in the literature as case presentations. It most commonly occurs due to high-energy trauma and may be accompanied by complications such as neural and vascular injuries or rotator cuff tears. Due to its rarity in clinical practice, it is a pathology that an orthopedic surgeon may encounter only once in their career. This case report describes the treatment process of a 57-year-old male patient who sustained bilateral inferior shoulder dislocation and massive irreparable rotator cuff tears following a 4-meter fall. The patient underwent arthroscopic subscapularis repair and latissimus dorsi tendon transfer with acromion osteotomy. At the one-year follow-up, forward elevation of the right shoulder improved from 35° to 170°, the American Shoulder and Elbow Surgeons (ASES) score increased from 33 to 98, and the Visual Analog Scale (VAS) score decreased from 5 to 1. For the left shoulder, forward elevation improved from 15° to 170°, the ASES score increased from 15 to 86, and the VAS score decreased from 8 to 2. This case demonstrates for the first time in the literature that a massive irreparable rotator cuff tear resulting from bilateral inferior shoulder dislocation can be effectively treated with latissimus dorsi tendon transfer, leading to excellent functional outcomes.