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J Reconstr Microsurg 2017; 33(04): 268-274
DOI: 10.1055/s-0036-1597835
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

YiChun Ding
1   Department of Plastic and Reconstructive Surgery, The Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui Province, China
,
Dong Sheng Cao
1   Department of Plastic and Reconstructive Surgery, The Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui Province, China
,
XueYing Huang
2   Department of Anatomy, Anhui Medical University, Hefei, Anhui Province, China
,
Juan Xie
1   Department of Plastic and Reconstructive Surgery, The Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui Province, China
,
HongHong Li
1   Department of Plastic and Reconstructive Surgery, The Second Affiliated Hospital, Anhui Medical University, Hefei, Anhui Province, China
› Author Affiliations
Further Information

Publication History

13 July 2016

16 November 2016

Publication Date:
28 January 2017 (online)

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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.

Keywords

anatomical study - segmental latissimus dorsi muscle transfer - dysfunction
 

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