Less is more - retrospective comparison of shoulder strength and range of motion between conventional and muscle-sparing harvesting technique of a latissimus dorsi flap.
Female
Functional Status
Humans
Male
Middle Aged
Muscle Strength
Neural Conduction
/ physiology
Neurologic Examination
/ methods
Organ Sparing Treatments
/ methods
Outcome and Process Assessment, Health Care
Physical Examination
/ methods
Postoperative Complications
/ diagnosis
Range of Motion, Articular
Plastic Surgery Procedures
/ adverse effects
Shoulder
/ physiopathology
Soft Tissue Injuries
/ etiology
Superficial Back Muscles
/ transplantation
Surgical Flaps
/ adverse effects
Defect reconstruction
Functional impairment
Latissimus dorsi flap
Muscle sparing latissimus dorsi flap
Journal
Journal of plastic, reconstructive & aesthetic surgery : JPRAS
ISSN: 1878-0539
Titre abrégé: J Plast Reconstr Aesthet Surg
Pays: Netherlands
ID NLM: 101264239
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
13
10
2020
revised:
14
01
2021
accepted:
26
02
2021
pubmed:
6
4
2021
medline:
18
11
2021
entrez:
5
4
2021
Statut:
ppublish
Résumé
The muscle-sparing latissimus dorsi flap poses an alternative to the conventional latissimus dorsi flap when a defect requires a smaller flap volume with a long vascular pedicle. The aim of the study was to analyze the functional outcome following muscle-sparing versus conventional harvest of a latissimus dorsi flap. Patients who received a muscle-sparing latissimus dorsi muscle flap transplantation (group 1) and patients with a complete latissimus dorsi muscle flap harvest (group 2) for defect reconstruction at the University Hospital of Erlangen between 2007 and 2016 were examined. The evaluation included a physical examination with the measurement of strength and range of motion of the shoulder of both the donor side as well as the nonoperated side. Furthermore, the DASH score was evaluated. Additionally, patients in group 1 received a neurophysiological examination. The DASH score did not show statistically significant differences between both groups. Both strength (p = 0.031) and range of motion (p<0.05) of the shoulder of the donor side were statistically significantly lower than the nonoperated side in group 2, while no difference was found in group 1. The neurophysiological examination in group 1 showed a reduced nerve conduction velocity of the donor side as compared to the nonoperated side in most patients (60% and n = 3). Harvesting the muscle-sparing latissimus dorsi flap leads to less functional impairments of the shoulder than harvesting the complete latissimus dorsi flap.
Sections du résumé
BACKGROUND
BACKGROUND
The muscle-sparing latissimus dorsi flap poses an alternative to the conventional latissimus dorsi flap when a defect requires a smaller flap volume with a long vascular pedicle. The aim of the study was to analyze the functional outcome following muscle-sparing versus conventional harvest of a latissimus dorsi flap.
MATERIAL AND METHODS
METHODS
Patients who received a muscle-sparing latissimus dorsi muscle flap transplantation (group 1) and patients with a complete latissimus dorsi muscle flap harvest (group 2) for defect reconstruction at the University Hospital of Erlangen between 2007 and 2016 were examined. The evaluation included a physical examination with the measurement of strength and range of motion of the shoulder of both the donor side as well as the nonoperated side. Furthermore, the DASH score was evaluated. Additionally, patients in group 1 received a neurophysiological examination.
RESULTS
RESULTS
The DASH score did not show statistically significant differences between both groups. Both strength (p = 0.031) and range of motion (p<0.05) of the shoulder of the donor side were statistically significantly lower than the nonoperated side in group 2, while no difference was found in group 1. The neurophysiological examination in group 1 showed a reduced nerve conduction velocity of the donor side as compared to the nonoperated side in most patients (60% and n = 3).
CONCLUSION
CONCLUSIONS
Harvesting the muscle-sparing latissimus dorsi flap leads to less functional impairments of the shoulder than harvesting the complete latissimus dorsi flap.
Identifiants
pubmed: 33814327
pii: S1748-6815(21)00084-X
doi: 10.1016/j.bjps.2021.02.007
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2527-2536Informations de copyright
Copyright © 2021 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors hereby state that there was no conflict of interest in the creation of this article.