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The latissimus dorsi muscle is among the most commonly used muscle flaps because it has broad versatility and is generally believed to result in minimal donor-site morbidity. However, the normal physiology of the shoulder girdle depends on the function of this muscle. Therefore, we have undertaken this review of the literature to examine the issue of biomechanical and functional changes of the shoulder that occur with transfer of the latissimus dorsi muscle and to determine whether these changes result in deficits in normal function. A review of the literature pertaining to all aspects of the latissimus muscle and shoulder function following muscle transfer was conducted. The latissimus muscle functions in extension, adduction, and internal and external rotation. After the transfer of the muscle there are deficits in extension and adduction. These deficits result in a faster rate of fatigue during activities in which the arms are extended over the head, such as ladder climbing and swimming. In addition, there is no decrease in range of shoulder motion.