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J Am Acad Orthop Surg, Vol 8, No 5, September/October 2000, 324-331.
© 2000 the American Academy of Orthopaedic Surgeons
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Use of the Pedicled Latissimus Muscle Flap for Upper-Extremity Reconstruction

Troy D. Pierce, MD, MS and Matthew M. Tomaino, MD

Dr. Pierce is Upper Extremity Surgeon, Bone and Joint Center, Bismarck, ND. Dr. Tomaino is Hand and Upper Extremity Surgeon and Associate Professor, University of Pittsburgh Medical Center, Pittsburgh, Pa.

Reprint requests: Dr. Tomaino, Suite 1010, Kaufmann Building, 3471 Fifth Avenue, Pittsburgh, PA 15213.

Tissue with a blood supply derived from a single constant vascular pedicle may be raised as a flap and rotated within the reach of its blood supply to cover and reconstruct a variety of complex wounds. The latissimus dorsi muscle makes an ideal pedicled flap because of its long neurovascular pedicle, large size, ease of mobilization, and expendability. It can be rotated, with or without overlying skin, to cover soft-tissue defects involving the shoulder, arm, and elbow, or it can be transferred as an innervated muscle to improve shoulder abduction as well as elbow flexion and extension. The major clinical applications of the pedicled latissimus dorsi muscle flap for upper-extremity reconstruction include use as a bipolar transfer to improve elbow flexion after trauma or brachial plexus injury and as a nonfunctioning myocutaneous transfer for coverage of nerves, bones, and joints after soft-tissue loss due to trauma, tumors, infection, or irradiation.




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 Ann. Surg. Oncol.Home page
A. B. Behnam, C. M. Chen, A. L. Pusic, B. J. Mehrara, J. J. Disa, E. A. Athanasian, and P. G. Cordeiro
The Pedicled Latissimus Dorsi Flap for Shoulder Reconstruction After Sarcoma Resection
Ann. Surg. Oncol., May 1, 2007; 14(5): 1591 - 1595.
[Abstract] [Full Text] [PDF]


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