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.
