Research ArticlesRepair of an Acute Latissimus Dorsi Tendon Rupture Using Bicortical Button FixationDoerre, Teresa MD*; Hallwachs, Alexander J. MD†; Fullick, Robert MD‡; Lowe, Walter R. MD‡Author Information *Department of Orthopaedic Surgery, The George Washington University, School of Medicine and Health Sciences †The George Washington University, School of Medicine and Health Sciences, Washington, DC ‡Department of Orthopedic Surgery, The University of Texas Health Science Center at Houston, Houston, TX The authors declare no conflict of interest. Reprints: Teresa Doerre, MD, Department of Orthopaedic Surgery, The George Washington University, School of Medicine and Health Sciences, 2300 I Street NW, Washington, DC 20037 (e-mail: [email protected]). Techniques in Shoulder & Elbow Surgery: September 2020 - Volume 21 - Issue 3 - p 70-75 doi: 10.1097/BTE.0000000000000195 Buy Metrics Abstract Acute latissimus dorsi tendon rupture is a rare injury, occurring nearly exclusively in athletes engaging in overhead motions. Given this patient population, return to elite function is a goal of treatment, often requiring surgery. When planning surgery, one finds a lack of sufficient evidence to recommend a specific fixation technique. We report a case of acute rupture of the latissimus dorsi in a competitive gymnast. Initial magnetic resonance imaging confirmed the injury and showed that the tendon had retracted 6 cm. Primary repair using bicortical button fixation, a novel fixation technique, was performed. The patient successfully returned to competition and reported personal best scores on high bar and parallel bars. Cadaveric studies comparing cortical buttons to sutures and suture anchors for tendon reattachment found cortical buttons to have higher loads to failure. Overall, this suggests the technique described here may provide superior outcomes for a patient population who will stress the repair at elite levels. Level of Evidence: Level V. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.