Dr.Tarek Said's Scientific Publications

The Reconstructive and functional role of latissmus Dorsi Flap in Complex Upper Extremity Injuries

Tarek Mahboub, M.D.*, Fouad Ghareeb, F.R.C.S.**, Tarek A. Said, M.D.*, and Wael S. Abdelnaser, M.D.*

The Departments of Plastic Surgery, Faculty of Medicine, Cairo* and El-Monofiya Universities.

Egypt. J. Plast. Reconstr. Surg., Vol (27), No (2),July, 2003: 255-261

Severe upper extremity injuries are considered a potential source of significant disability. Appropriate soft tissue restoration is an essential component of any treatment protocol and often requires a vascularized flap to protect the neurovascular and musculo-tendinous structures. The use of latissmus dorsi muscle or musculo-cutaneous flaps is considered an ideal solution in such conditions as it provides reliable, well vascularized soft tissue coverage to an extensive surface area. Also, it could provide a functional unit , as well as, to compensate for flexion or extension deficits at the elbow resulting from traumatic loss of the effective muscle power for elbow flexion or extension. Latissmus dorsi pedicled muscle or musculo-cutaneous flaps were used for immediate soft tissue coverage in twenty-three patients with complex upper extremity injuries involving the arm and elbow. The muscle flap was used as a functional unit for elbow reanimation in 5 patients. The results were satisfactory with accelerated postoperative recovery and return of functional activity. Limb salvage was achieved in all patients except one with vascular graft occlusion that necessitated above elbow amputation. The advantages of immediate coverage of such defects with latissmus dorsi flap were appreciated and it was concluded that this flap could be considered the flap of choice for such defects.

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