Segmental Latissimus Dorsi Free Flap Attempting to Preserve Function at the Donor Site: Anatomical and Clinical Experiences

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Abstract

Background

The purpose of the present study was to evaluate arm and shoulder function prospectively after transfer of the lateral segment of the latissimus dorsi (LD) muscle.

Methods

In this study, 20 specimens of LD muscles from 10 cadavers were dissected to determine the relationship between the artery and the nerve. Twenty patients were recruited and functional disability was determined by the Disabilities of Arm, Shoulder, and Hand (DASH), and muscle strength by needle electromyography (EMG) before surgery and at five different time points postoperatively.

Results

Two specimens (10%) had no medial branch arising from the thoracodorsal artery. The pedicle length of the lateral branch was longer than that of the medial branch (mean 10.41 vs. 9.27 cm, p = 0.03). All DASH scores and EMG amplitudes at half a month postoperative decreased compared with those preoperatively, with no significant difference at 3 months postoperative.

Conclusion

Lateral segmental LD muscle transfer, leaving the residual segment motor function intact, can be recommended as an alternative for moderate and small-size bone exposure wounds, especially in the lower extremities, that minimizes loss of donor-site function.

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