Pedicled Latissimus Dorsi Transfer for Immediate Soft-Tissue Coverage and Elbow Flexion

Mordick, Thomas G.; Britton, Eric N.; Brantigan, Charles O.

doi:10.1097/00006534-199705010-00043

Cited by 19 publications

(10 citation statements)

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“…However, isokinetic absolute torque is comparable between the two subjects. Compared to the 20-month follow-up study of Mordick et al [15], our patient showed less strength differences between the injured and the healthy side. A comparison is only partly possible because of the different injury area and other muscles involved in the test situation.…”

Section: Discussioncontrasting

confidence: 79%

“…The latissimus dorsi as donor site muscle was used in this time period only in 11% of all cases. Mordick et al [15] showed that latissimus dorsi transfer after extensive soft tissue loss was successful in restoring active elbow flexion in a patient who returned to competitive high school volleyball thereafter. The reported strength differences in the injured versus uninjured extremity was 8-25 lb.…”

Section: Discussionmentioning

confidence: 99%

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Funktionelles Resultat und biomechanische Untersuchungen nach Tumor-Resektion im Bereich des Schultergürtels (Fallbericht)

et al. 2009

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Zusammenfassung. Grundlagen: Es wird ein 20-jähriger Mann vorgestellt, der wegen eines ausgedehnten Desmoidtumors im Schulterbereich marginal reseziert worden ist und intra-und postoperativ nachbestrahlt wurde.Methodik: Weite Teile des Schultergürtels waren von Tumorgewebe infiltriert weshalb der ventrale Teil des M. deltoideus, zwei Drittel des M. pectoralis major, der M. pectoralis minor, das Schlüsselbein und Teile der Kapsel des Schultergelenks entfernt wurden. Die Rekonstruktion der Muskelfunktion erfolgte durch einen gesplitteten M. latissimus dorsi, welcher mit Meshgraft bedeckt wurde.Ergebnisse: 3 Jahre postoperativ ist der Mann als Bäcker voll berufstätig, lediglich die Adduktion ist durch das Fehlen des Schlüsselbeins eingeschränkt. Am Institut für Sportwissenschaft wurde die globale Schulterfunktion gemessen und das klinisch gute Ergebnis bestätigt.Schlussfolgerungen: Ausgedehnte Tumorresektionen im Schulterbereich sind heute bei guter Planung und radikaler Durchführung der Operation mit einzeitiger Rekonstruktion und sehr früh postoperativ eingesetztem Rehabilitationsprogramm möglich. Sportmedizinische Messungen der globalen Schulterfunktion können zur Optimierung des Rehabilitationsprogramms wertvolle Hinweise liefern. Schlüsselwörter: Tumor, Schultergü rtel, Rekonstruktion, gesplitteter M. latissimus dorsi-Lappen, funktionelles Ergebnis, biomechanische Untersuchungen. Summary. Background: A 20-year-old male with a large extra-abdominal fibromatosis of the left shoulder girdle underwent marginal tumor resection, postopoperative radiation therapy and reconstruction with a split latissimus dorsi flap.Methods: Owing to the tumor involving major parts of the shoulder girdle, the clavicular part of the deltoideus and cranial parts of the pectoralis major and pectoralis minor muscle, parts of the coracobrachial muscle, the clavicle and the coracoid process had to be resected. The reconstruction of the different muscles was performed with a split latissimus dorsi muscle (LD) covered with mesh graft. The LD flap was chosen for its size, ability for compartmentalization, arc of rotation, vascularization and innervation and minimal donor-site morbidity. Owing to the marginal resection of the tumor, intra-and postoperative radiation therapy followed.Results: The patient has regained excellent function in his left upper extremity and is able to continue his profession as a baker with the exception of adduction being weaker than the contralateral side caused by the missing clavicle.Conclusions: The transfer of a split latissimus dorsi muscle is an effective procedure to cover defects and restore muscles with different function after extended tumor resection in the region of the shoulder girdle. The functional outcome is excellent and measurements by sport scientists are able to gain valuable results for optimizing the rehabilitation program.

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Section: Discussioncontrasting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Funktionelles Resultat und biomechanische Untersuchungen nach Tumor-Resektion im Bereich des Schultergürtels (Fallbericht)

et al. 2009

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“…For reconstruction of the region, successful examples of axial fasciocutanous flaps such as radial forearm and reverse lateral arm flaps, interpolation flaps elevated form abdominal region, pediculed lattissimus dorsi musculocutenous flap and various free flaps are defined throughout the literature [1,[3][4][5].…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of elbow defect with radial collateral artery perforator flap

Dağdelen¹

2017

Hand Microsurg

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Background: Distal fingertip amputations with exposed bone is challenging for the surgeon to manage. In order to reconstruct a good sensate pulp with appropriate closure, various flaps are advocated in the literature. Of these, palmar advancement flap, first described by Moberg in 1964, comprises one of the most popular options. Methods: Thirteen patients (11 male, 3 female) with fingertip injuries were operated. Following the elevation of Moberg flap, proposed modifications were carried out. Joint mobility and pulp sensitivity were recorded as well and advancement scores were noted before and after the modification. These scores were assessed statistically. Results: No complications were noted and there was no need for additional surgery. Excellent joint mobility and pulp sensitivity were maintained. This modification showed a statistically significant improvement in the advancement (p<0.05). Conclusions: Moberg flap is a good option for the closure of fingertip defects. Some simple modifications, as described in here, can enhance the advancement while securing the entire advantages of the flap. IntroductionThe hand is a unique part in the body in and plays important and often irreplaceable functions. In the industrialized world, occupational hand injuries need to be healed as soon as possible. Meanwhile, several healing techniques with various options are being applied to hundreds of thousands of patients by experienced practitioners.Unlike other hand injuries, fingertip amputations need additional attention in order to establish a normal pulp sensibility and maximum range of motion, and like others to maintain the upmost level of hand functioning.In 1964, the volar advancement flap was first described by Moberg for the reconstruction of pulp defects of the thumb (1). This flap is a pedicled advancement flap proximally based on an intact skin pedicle including both neurovascular bundles. This technique establishes a successful neurosensation of the pulp with a limited advancement as well. However, a simple modification as described here, and never been reported elsewhere, can enhance additional advancement. Patients and MethodsThe study was performed with informed consents obtained from all participants.Technique Thirteen patients (11 males, 3 females) with fingertip injuries were operated under regional anaesthesia. Palmar advancement flap was raised over the parathenon (1) (Figure 1a). Both neurovascular bundles were included in the flap so that neurosensible coverage is accomplished (Figure 1b). To increase the Hand Microsurgery & ABSTRACTElbow defects form a challanging subgroup to reconstruct among upper extremity defects. We aimed to present a succesful case of elbow defect reconstructed by a Radial Collateral Artery Perforator Flap (RCAPF), also to discuss the advantages and applicability of this flap in light of current literature.

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“…The neurovascular supply to this muscle allows the latissimus to also be rotated as a functional muscle transfer to restore biceps or triceps function independently or in combination with soft-tissue coverage. [53][54][55][56][57][58][59][60][61][62][63][64][65][66] Absolute contraindications for this flap are patient conditions that require use of crutches or a wheelchair. Paraplegia, severe lower extremity injuries, ipsilateral shoulder girdle weakness, previous operations about the shoulder girdle, previous trauma affecting the subclavian or axillary artery, tumor resection, or lymph node dissection in the area of the thoracodorsal artery and nerve are contraindications.…”

Section: Distant Muscle Rotational Flap: Latissimus Dorsimentioning

confidence: 99%

Soft-Tissue Coverage of the Elbow

Stevanović

Sharpe

2013

Plastic and Reconstructive Surgery

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The elbow requires a durable and pliable soft-tissue envelope. Injuries, infections, or tumors that result in exposed tendon, bone, or implants require expedient soft-tissue coverage. Familiarity with various options for coverage can help tailor treatment to the defect size and minimize donor-site morbidity. In this article, emphasis is placed on muscle and fasciocutaneous flaps that have been shown to have reliable vascularity and predictable outcomes.

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Pedicled Latissimus Dorsi Transfer for Immediate Soft-Tissue Coverage and Elbow Flexion

Cited by 19 publications

References 0 publications

Funktionelles Resultat und biomechanische Untersuchungen nach Tumor-Resektion im Bereich des Schultergürtels (Fallbericht)

Funktionelles Resultat und biomechanische Untersuchungen nach Tumor-Resektion im Bereich des Schultergürtels (Fallbericht)

Reconstruction of elbow defect with radial collateral artery perforator flap

Soft-Tissue Coverage of the Elbow

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